Clinical Characteristics of Two Gynecologic Cancer Patients on Treatment Infected with SARS-Cov-2 Infection in Jimma, Ethiopia View PDF

*Tafese Dejene Jidha
Department Of Obstetrics And Gynecology, Jimma University Medical Center, Jimma, Ethiopia

*Corresponding Author:
Tafese Dejene Jidha
Department Of Obstetrics And Gynecology, Jimma University Medical Center, Jimma, Ethiopia
Email:dejtafese@gmail.com

Published on: 2020-12-12

Abstract

Background: The outbreak of coronavirus disease 2019 (COVID-19) emerged in late 2019 in Wuhan, China, and has been spreading rapidly. As the infection has become widespread, concern for the influence of COVID-19 on patients with cancer has grown. Individuals with cancer, particularly those who are receiving systemic anticancer treatments, have been postulated to be at increased risk of mortality from COVID-19 due to highly immunosuppressive chemotherapy regimens and possible exposure to COVID-19 during the treatment. In these case reports, we aimed to discuss the outcome of patients with gynecologic cancers on management with COVID-19.
Case presentation: We present the clinical features of two cancer patients who were infected with SARS-CoV-2 in late June 2020 in our hospital. Case one was a 23 years old patient diagnosed to have stage IIIC malignant ovarian tumor who was on neoadjuvant chemotherapy (Cisplatin and Paclitaxol) infected with COVID-19. Case two was 36 years old patient diagnosed to have stage 1b1 squamous cell cervical carcinoma for whom type 3 radical hysterectomy and pelvic lymphadenectomy was done. She was asymptomatic and she was tested and became positive after she had contact history with COVID-19 positive patient. Both survived from the viral infection. They acquired SARS-CoV-2 infection during their stay in hospital under chemotherapy and surgery of the tumor.
Conclusion: Chemotherapy or surgical management for gynecologic cancer is not linked to higher COVID-19 mortality risk. So, patients should not only continue to receive their screening and preventive measures but also continue with active therapy for cancer, such as surgery and chemotherapy, to optimize their cancer outcomes.

Keywords

COVID-19; Advanced Stage Ovarian Cancer; Neoadjuvant Chemotherapy; Type III Radical Hysterectomy; Cervical Cancer

Background

In December 2019, a cluster of cases of pneumonia was reported by Wuhan Municipal Health Commission, China, and then a novel coronavirus was eventually identified [1]. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly infectious and can infect all individuals. As of 28 August 2020, 213 Countries and Territories around the world have reported a total of 24,809,018 confirmed cases of the coronavirus COVID-19 and a death toll of 838,799 deaths. Deaths from COVID-19 have been caused by multiple organ dysfunction syndromes rather than respiratory failure [2], which might be attributable to the widespread distribution of angiotensin-converting enzyme 2-the functional receptor for SARS-CoV- 2-in multiple organs [3]. Risk factors for severe outcomes and death from COVID-19 infection include older age and medical comorbidities, characteristics that are common in cancer patients. It was postulated that patients with cancers were more susceptible to infection than individuals without cancer because of their systemic immunosuppressive state caused by the malignancy and anticancer treatments, such as chemotherapy or surgery. Therefore, these patients might be at increased risk of COVID-19 and might have a poorer prognosis. Here, we report on 2 gynecologic cancer patients infected with SARS CoV-2 in late June of 2020 and describe their clinical diagnosis, management and outcomes.

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