SARS-CoV-2 Infection and High-Risk Non-Muscle-Invasive Bladder Cancer: Are There Any Common Features?

The new severe acute respiratory syndrome virus (SARS-CoV-2) outbreak is a huge health, social and economic issue and has been declared a pandemic by the World Health Organization. Bladder cancer, on the contrary, is a well-known disease burdened by a high rate of affected patients and risk of recurrence, progression and death.

The coronavirus disease (COVID-19 or 2019-nCoV) often involves mild clinical symptoms but in some cases, it can lead to pneumonia with acute respiratory distress syndrome and multiorgan dysfunction. Factors associated with developing a more severe disease are increased age, obesity, smoking and chronic underlying comorbidities (including diabetes mellitus). High-risk non-muscle-invasive bladder cancer (NMIBC) progression and worse prognosis are also characterized by a higher incidence in patients with risk factors similar to COVID-19. Immune system response and inflammation have been found as a common hallmark of both diseases. Most severe cases of COVID-19 and high-risk NMIBC patients at higher recurrence and progression risk are characterized by innate and adaptive immune activation followed by inflammation and cytokine/chemokine storm (interleukin [IL]-2, IL-6, IL-8). Alterations in neutrophils, lymphocytes and platelets accompany the systemic inflammatory response to cancer and infections. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for example have been recognized as factors related to poor prognosis for many solid tumors, including bladder cancer, and their role has been found important even for the prognosis of SARS-CoV-2 infection. Key Messages: All these mechanisms should be further analyzed in order to find new therapeutic agents and new strategies to block infection and cancer progression. Further than commonly used therapies, controlling cytokine production and inflammatory response is a promising field.

Urologia internationalis. 2020 Jun 09 [Epub ahead of print]

Gian Maria Busetto, Angelo Porreca, Francesco Del Giudice, Martina Maggi, Daniele D'Agostino, Daniele Romagnoli, Gennaro Musi, Giuseppe Lucarelli, Katie Palmer, Ascanio Colonna di Paliano, Matteo Muto, Rodolfo Hurle, Daniela Terracciano, Ottavio de Cobelli, Alessandro Sciarra, Ettore De Berardinis, Matteo Ferro

Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy, ., Department of Urology, Abano Terme Policlinic, Abano Terme, Italy., Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy., Division of Urology, IEO European Institute of Oncology IRCCS, Milan, Italy., Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy., Department of Internal Medicine and Geriatrics, Cattolica del Sacro Cuore University, Rome, Italy., Digital Design Kingdom, Rome, Italy., Radiotherapy Unit, S.G. Moscati Hospital, Avellino, Italy., Department of Urology, Humanitas Research Hospital, Milan, Italy., Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy.

email news signup