2.4 COVID-9 infection and renal
cancer
Cancer patients undergoing cancer chemotherapy are among those likely to
be easily infected with SARS-CoV-2 due to drug-related immunosuppression
(Ofori-Asenso et al., 2020; Mihalopoulos et al., 2020). Globally, renal
cell carcinoma (RCC) represents the 6th and
10th most diagnosed cancer in men and women, and
accounts for 5% and 3% of all cancers in males and females
respectively (Wallis et al., 2020). A recent study revealed predominant
expression of coronavirus receptors (CoV; DPP4, ANPEP, ENPEP) in clear
cell RCC and also in other forms of renal cancers such as papillary and
chromophobe subtypes (Tripathi et al., 2020). This finding confirms
increased risk of SARS-CoV-2 infection in these groups of patients.
Hence, a number of strategies have been proposed and employed to provide
care for these patients in this COVID-19 era, including postponing
chemotherapy, minimizing elective surgical procedures in patients with
stable cancer as well as in those patients at high risk for ending up in
the intensive care units following surgery (Al-Quteimat and Amer, 2020).
In the light of these strategies, recommendations for the deferment for
cytoreductive nephrectomy in patients with metastatic RCC in this
COVID-19 era and replacement with systemic therapy for patients with
intermediate to poor-risk disease has been made (Ged et al., 2020).
Current data from a study gives both medical practitioners and patients
some hope, as surgery can be safely delayed in a subgroup of patients
with RCC to between 3 and 6 months without significant sacrifice in
overall survival (Srivastava et al., 2021). Overall, patients with RCC
and other forms of renal cancer, who are undergoing cancer chemotherapy
are at a higher risk of COVID-19 infection, which could further
exacerbate their kidney condition.