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Severe COVID-19 raises alarm for undiagnosed cancer

Severe COVID-19 raises alarm for undiagnosed cancer

In a recent study published within the journal Scientific Reports, researchers investigated whether the severity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was indicative of undiagnosed cancer.

Study: Severe SARS-CoV-2 infection as a marker of undiagnosed cancer: a population-based study. Image Credit: Tyler Olson / Shutterstock.com


Studies conducted throughout the coronavirus disease 2019 (COVID-19) pandemic reported that male sex, older age, and comorbidities similar to chronic diseases and energetic cancers increased the chance of hospitalization and mortality as a consequence of SARS-CoV-2 infection. Individuals with energetic cancers were also at a comparatively higher risk of COVID-19-associated mortality, even in the event that they were vaccinated.

The six aspects that increased the morbidity and mortality risk of cancer patients to SARS-CoV-2 infections were age, increased expression of the angiotensin-converting enzyme 2 (ACE-2) receptor transmembrane serine protease 2 (TMPRSS2)immunosuppression as a consequence of cancer treatments, in addition to a pro-coagulant state and inflammatory responses induced by cancer. A few of these aspects could influence the susceptibility to severe SARS-CoV-2 infections in individuals with undiagnosed cancers.

Concerning the study

In the current study, researchers used data from the French Système National des Données de Santé (SNDS) database. This database has been used for various pharmacological and epidemiological studies, because it comprises healthcare reimbursement data for all the population of France.

The SNDS database consists of 1 section with information on ambulatory medical care reimbursements, including laboratory tests, ambulatory medical care, and prescribed drugs, whereas the opposite section consists of knowledge on hospital admissions, discharges, medical procedures, and diagnoses.

From anonymized data, specific medical algorithms were used to discover pathologies, causes for hospitalization, long-term illness diagnoses, and treatment reimbursements. The study included data on intensive care unit (ICU) admissions between February 15, 2020, and August 31, 2021, which covered the period between the onset of the COVID-19 pandemic and the top of the fourth wave in France. The follow-up was prolonged to the top of December 2021 to permit for a four-month follow-up for ICU-admitted patients.

The study included data on individuals above the age of 16 who had availed of at the least one reimbursement within the two years before the index date and had no cancer diagnoses within the previous five years. Nursing home residents and twins below the age of twenty-two were excluded from the study.

Study participants were categorized into two groups, the primary of which included those admitted into the ICU. The second group included age, sex, and French department-matched controls who weren’t hospitalized.

Information on sex, age, area of residence, and socio-economic status were determined, and co-variables similar to existing comorbidities, COVID-19 vaccination status, treatment with corticosteroids or immunosuppressants, and addictive disorders were analyzed.

The examined final result included the incidence of cancer throughout the follow-up period in either of the 2 groups. An incidence of cancer was defined as hospitalization as a consequence of any cancer or cancer-like condition requiring reimbursement.

Participants were excluded from the evaluation after the initial inclusion in case of death in either of the groups. Moreover, individuals from the control group who were hospitalized as a consequence of SARS-CoV-2 infection were subsequently faraway from the control group and added to the ICU-admission group.

COVID-19 hospitalization and increased risk of cancer

A complete of 897 of the 41,302 individuals admitted to the ICU with SARS-CoV-2 infection were diagnosed with cancer throughout the follow-up months as in comparison with 10,944 of the 713,670 controls diagnosed with cancer. In truth, individuals who had been admitted to the ICU had a 1.31 times higher risk of a cancer diagnosis than those that didn’t require hospitalization for SARS-CoV-2 infection.

When the follow-up period was decreased to 3 months or if only the feminine population was considered, the association between ICU admission and cancer diagnosis was stronger. Moreover, as in comparison with controls, individuals within the ICU group were more more likely to be diagnosed with hematological, renal, lung, or colon cancers. Other kinds of cancers didn’t show significant differences between the 2 groups.

While the study didn’t discuss any causal effect between SARS-CoV-2 infection and the event of cancer throughout the follow-up period, the researchers speculated on the differences within the screening and diagnosis techniques between the 2 groups that might have led to a detection bias.

Individuals admitted to the ICU with SARS-CoV-2 infection may need been subjected to repetitive lung scans and blood tests, which could have led to the detection of lung or hematological cancers. Comparatively, prostate-specific antigen tests or mammograms won’t have been a priority throughout the ICU admission, thereby leading to lower detection of prostate or breast cancers, respectively.

In contrast, individuals within the control group may need been screened for other cancers, as they were in a greater health condition to undergo these tests.


Individuals who experienced severe SARS-CoV-2 infection requiring ICU admission were at a greater risk of being diagnosed with cancer throughout the following months than individuals who didn’t require hospitalization for COVID-19. While there’s a possible for detection bias, these results indicate that severe SARS-CoV-2 infection could possibly be a marker for undiagnosed cancer.

Journal reference:

  • Dugerdil, A., Semenzato, L., Weill, A. et al. (2023). Severe SARS-CoV-2 infection as a marker of undiagnosed cancer: a population-based study. Scientific Reports 13(8729). doi:10.1038/s41598-023-36013-7


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