COVID-19 burden of illness in people who are immunocompromised due to cancer: an expert opinion review

Abstract

From the beginning of the pandemic, people with cancer have experienced a high burden from COVID-19 compared with the general population, both in terms of severe COVID-19-related outcomes and reduced health-related quality of life and mental health. This review presents and discusses expert views on the burden of COVID-19 in individuals with cancer throughout the pandemic. The literature suggests that early in the pandemic, people with cancer had a disproportionately high risk of COVID-19-related hospitalization compared with the general population. This trend continued throughout the pandemic, even after the availability of vaccinations (including boosters) and the emergence of less virulent strains. Rates of hospitalization, intensive care unit admission, and mechanical ventilation varied across studies but were all seen to be higher in people with cancer and COVID-19 compared with the general population or those with cancer alone. Moreover, studies indicated worsened quality of life and mental health in these people during the pandemic and lockdown periods compared with prepandemic or postlockdown periods. Although COVID-19 has entered the endemic phase and is no longer a global health emergency, it remains a significant risk for people with cancer. Generally, COVID-19 continues to increase healthcare resource use, impair mental health, and reduce quality of life in this population, highlighting the need for continued real-world studies. Ongoing research is essential to evaluate the impact of COVID-19 on vaccinated people with cancer, particularly those undergoing systemic cancer therapy who may require continued guidance on preventive measures and treatments to mitigate the risk of severe COVID-19.