AUTHOR=Wang Qianqian , Li Liangyu , Qu Tianyu , Li Jie , Wu Lingxiang , Li Kening , Wang Ziyu , Zhu Mengyan , Huang Bin , Wu Wei , Wu Min , Ding Rong , Zhang Zhihong , Wang Qianghu , Xia Xinyi , Li Pengping , Zhang Zhi , Guo Renhua 

TITLE=High Expression of ACE2 and TMPRSS2 at the Resection Margin Makes Lung Cancer Survivors Susceptible to SARS-CoV-2 With Unfavorable Prognosis

JOURNAL=Frontiers in Oncology

VOLUME=11

YEAR=2021

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2021.644575

DOI=10.3389/fonc.2021.644575

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p>Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide. Systematic analysis of lung cancer survivors at molecular and clinical levels is warranted to understand the disease course and clinical characteristics.</p></sec><sec><title>Methods</title><p>A single-center, retrospective cohort study was conducted in 65 patients with COVID-19 from Wuhan Huoshenshan Hospital, of which 13 patients were diagnosed with lung cancer. The study was conducted from February 4 to April 11, 2020.</p></sec><sec><title>Results</title><p>During the course of treatment, lung cancer survivors infected with severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) had shorter median time from symptom onset to hospitalization (<italic>P</italic> = 0.016) and longer clinical symptom remission time (<italic>P</italic> = 0.020) than non-cancer individuals. No differences were observed among indicators such as time from symptom onset to hospitalization and symptom remission time between medium-term and short-term survivors. The expression of <italic>ACE2</italic> (<italic>P</italic> = 0.013) and <italic>TMPRSS2</italic> (<italic>P &lt;</italic>0.001) was elevated in lung cancer survivors as compared with that in non-cancer individuals.</p></sec><sec><title>Conclusions</title><p><italic>ACE2</italic> and <italic>TMPRSS2</italic> levels were higher at resection margins of lung cancer survivors than those in normal tissues of non-cancerous individuals and may serve as factors responsible for the high susceptibility to COVID-19 among lung cancer survivors. Lung cancer patients diagnosed with COVID-19, including medium-term survivors, have worse outcomes than the general population.</p></sec>