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The Challenges of COVID-19 with Obesity-Related Cancers

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Epidemiology and Prevention".

Deadline for manuscript submissions: 25 April 2024 | Viewed by 43728

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Special Issue Editors

Prof. Dr. Maria Dalamaga

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Guest Editor

Department of Biological Chemistry, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
Interests: biomarkers; metabolism; cancer; inflammation; microbiome; cardiometabolic disorders

Dr. Narjes Nasiri-Ansari

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Guest Editor

Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
Interests: cardiometabolic diseases; NAFLD; CVDs; atherosclerosis; diabetes; inflammation; nuclear receptors; circadian clock system

Dr. Nikolaos Spyrou

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Guest Editor

Department of Oncological Scienses, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Interests: cancer; biomarkers; metabolism; microbiome

Special Issue Information

Dear Colleagues,

The emergence of COVID-19 has created an unprecedented threat worldwide. The COVID-19 pandemic has taken place at a time when the worldwide prevalence rate of overweight and obesity is greater than 39% for adults, and cancer is a leading cause of death globally based on WHO data. Interestingly, obesity has been reported as a significant risk factor for the severity of COVID-19. Moreover, there is convincing evidence that excess body weight is associated with an increased risk for cancer of at least 13 anatomic sites, including endometrial, esophageal, renal and pancreatic adenocarcinomas; hepatocellular carcinoma; gastric cardia cancer; meningioma; multiple myeloma; colorectal, postmenopausal breast, ovarian, gallbladder and thyroid cancers.

Cancer patients may be more susceptible to being infected with the SARS-CoV-2 virus. Patients with ongoing or recent cancer treatment for advanced active disease, metastatic solid tumors and hematological malignancies present an elevated risk of severe COVID-19, hospitalization and mortality. This Special Issue will place emphasis on the challenges surrounding COVID-19- and obesity-related cancers, including, but not limited to: risk factors of severe COVID-19 in cancer patients; complications of COVID-19 in cancer patients; challenges in cancer treatment and surgery; guidelines for cancer care during COVID-19; delayed diagnosis and suboptimal cancer management; impact of COVID-19 on cancer screening, early diagnosis and cancer presentation; immune response after SARS-CoV-2 infection and vaccination in cancer patients; psychological distress among cancer survivors; telehealth in cancer care; role of diet and nutraceuticals in the prevention of severe COVID-19 and cancer; effects of COVID-19 pandemic on cancer research, etc.

Based on your expertise in this field, we would like to invite you to contribute with a review or research paper for peer review and possible publication in this Special Issue. Cancers is indexed in PubMed and SCIE with an Impact Factor of 6.639 (2020).

Prof. Dr. Maria Dalamaga
Dr. Narjes Nasiri-Ansari
Dr. Nikolaos Spyrou
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

biomarkers
cancer
cancer care
COVID-19
inflammation
immune response
metabolic disorders
obesity
psychological distress
screening
telehealth
vaccines

Published Papers (13 papers)

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Editorial

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8 pages, 680 KiB

Open AccessEditorial

Perspectives and Challenges of COVID-19 with Obesity-Related Cancers

by Maria Dalamaga, Narjes Nasiri-Ansari and Nikolaos Spyrou

Cancers 2023, 15(6), 1771; https://doi.org/10.3390/cancers15061771 - 15 Mar 2023

Cited by 1 | Viewed by 1460

Abstract

The emergence of COVID-19 has created an unprecedented threat worldwide, involving overwhelmed health-care systems in the majority of countries [...] Full article

(This article belongs to the Special Issue The Challenges of COVID-19 with Obesity-Related Cancers)

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Research

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16 pages, 324 KiB

Open AccessArticle

Effect of Obesity among Hospitalized Cancer Patients with or without COVID-19 on a National Level

by Jonathan Cottenet, Solène Tapia, Patrick Arveux, Alain Bernard, Tienhan Sandrine Dabakuyo-Yonli and Catherine Quantin

Cancers 2022, 14(22), 5660; https://doi.org/10.3390/cancers14225660 - 17 Nov 2022

Cited by 1 | Viewed by 1283

Abstract

Cancer and obesity are well-known prognostic factors in COVID-19. Our objective was to study the effect of obesity (and its severity) on the risk of intensive care unit (ICU) admission, severe complications, and in-hospital mortality, in a population of cancer patients hospitalized with or without COVID-19. All patients hospitalized in France for cancer from 1 March 2020 to 28 February 2022 were included from the French national administrative database. The effect of obesity was estimated in COVID-19 and in non-COVID-19 cancer patients using logistic and survival regressions, taking into account age, sex, comorbidities, and different types of cancer. Among the 992,899 cancer patients, we identified 53,090 patients with COVID-19 (5.35%), of which 3260 were obese (6.1%). After adjustment, for patients with or without COVID-19, there is an increased risk of ICU admission or severe complications in obese patients, regardless of the type of obesity. Regarding in-hospital mortality, there is no excess risk associated with overall obesity. However, massive obesity appears to be associated with an increased risk of in-hospital mortality, with a significantly stronger effect in solid cancer patients without COVID-19 and a significantly stronger effect in hematological cancer patients with COVID-19. This study showed that in France, among hospitalized patients with cancer and with or without COVID-19, increased vigilance is needed for obese patients, both in epidemic and non-epidemic periods. This vigilance should be further strengthened in patients with massive obesity for whom the risk of in-hospital mortality is higher, particularly in epidemic periods for patients with hematological cancers. Full article

(This article belongs to the Special Issue The Challenges of COVID-19 with Obesity-Related Cancers)

13 pages, 1237 KiB

Open AccessFeature PaperArticle

A Multicenter Analysis of the Outcome of Cancer Patients with Neutropenia and COVID-19 Optionally Treated with Granulocyte-Colony Stimulating Factor (G-CSF): A Comparative Analysis

by María Sereno, Ana María Jimenez-Gordo, Javier Baena-Espinar, Carlos Aguado, Xabier Mielgo, Ana Pertejo, Rosa Álvarez-Álvarez, Ana Sánchez, Jose Luis López, Raquel Molina, Ana López-Alfonso, Berta Hernández, Luis Enrique Chiara, Ana Manuela Martín, Ana López-Martín, Miriam Dorta, Ana Collazo-Lorduy, Enrique Casado, Ana Ramirez de Molina and Gonzalo Colmenarejo

Cancers 2021, 13(16), 4205; https://doi.org/10.3390/cancers13164205 - 20 Aug 2021

Cited by 14 | Viewed by 3180

Abstract

Background: Approximately 15% of patients infected by SARS-CoV-2 develop a distress syndrome secondary to a host hyperinflammatory response induced by a cytokine storm. Myelosuppression is associated with a higher risk of infections and mortality. There are data to support methods of management for neutropenia and COVID-19. We present a multicenter experience during the first COVID-19 outbreak in neutropenic cancer patients infected by SARS-CoV-2. Methods: Clinical retrospective data were collected from neutropenic cancer patients with COVID-19. Comorbidities, tumor type, stage, treatment, neutropenia severity, G-CSF, COVID-19 parameters, and mortality were analyzed. A bivariate analysis of the impact on mortality was carried out. Additionally, we performed a multivariable logistic regression to predict respiratory failure and death. Results: Among the 943 cancer patients screened, 83 patients (11.3%) simultaneously had neutropenia and an infection with COVID-19. The lungs (26%) and breasts (22%) were the primary locations affected, and most patients had advanced disease (67%). In the logistic model, as adjusted covariates, sex, age, treatment (palliative vs. curative), tumor type, and the lowest level of neutrophils were used. A significant effect was obtained for the number of days of G-CSF treatment (OR = 1.4, 95% CI [1,1,03,92], p-value = 0.01). Conclusions: Our findings suggest that a prolonged G-CSF treatment could be disadvantageous for these cancer patients with infections by COVID-19, with a higher probability of worse outcome. Full article

(This article belongs to the Special Issue The Challenges of COVID-19 with Obesity-Related Cancers)

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Review

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31 pages, 1294 KiB

Open AccessReview

Cancer Patients and the COVID-19 Vaccines: Considerations and Challenges

by Muna Almasri, Khalifa Bshesh, Wafa Khan, Malik Mushannen, Mohammad A. Salameh, Ameena Shafiq, Ahamed Lazim Vattoth, Nadine Elkassas and Dalia Zakaria

Cancers 2022, 14(22), 5630; https://doi.org/10.3390/cancers14225630 - 16 Nov 2022

Cited by 4 | Viewed by 2580

Abstract

Few guidelines exist for COVID-19 vaccination amongst cancer patients, fostering uncertainty regarding the immunogenicity, safety, and effects of cancer therapies on vaccination, which this review aims to address. A literature review was conducted to include the latest articles covering the immunogenicity and safety of COVID-19 vaccination in patients with solid and hematologic cancers receiving various treatments. Lower seropositivity following vaccination was associated with malignancy (compared to the general population), and hematologic malignancy (compared to solid cancers). Patients receiving active cancer therapy (unspecified), chemotherapy, radiotherapy, and immunosuppressants generally demonstrated lower seropositivity compared to healthy controls; though checkpoint inhibition, endocrine therapy, and cyclin dependent kinase inhibition did not appear to affect seropositivity. Vaccination appeared safe and well-tolerated in patients with current or past cancer and those undergoing treatment. Adverse events were comparable to the general population, but inflammatory lymphadenopathy following vaccination was commonly reported and may be mistaken for malignant etiology. Additionally, radiation recall phenomenon was sporadically reported in patients who had received radiotherapy. Overall, while seropositivity rates were decreased, cancer patients showed capacity to generate safe and effective immune responses to COVID-19 vaccination, thus vaccination should be encouraged and hesitancy should be addressed in this population. Full article

(This article belongs to the Special Issue The Challenges of COVID-19 with Obesity-Related Cancers)

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8 pages, 247 KiB

Open AccessReview

Breast Cancer and COVID-19: Challenges in Surgical Management

by Zoe Petropoulou, Nikolaos Arkadopoulos and Nikolaos V. Michalopoulos

Cancers 2022, 14(21), 5360; https://doi.org/10.3390/cancers14215360 - 31 Oct 2022

Cited by 3 | Viewed by 1324

Abstract

The harsh healthcare reality imposed by the COVID-19 pandemic resulted in wide clinical practice alterations, postponements, and shortages, affecting both patients and caregivers. Breast-cancer management, from diagnosis to treatment and follow up, was a field that did not escape such changes, facing a challenging set of obstacles in order to maintain adequate cancer care services while diminishing viral spread among patients and personnel. In this review article, we discuss the impact of the COVID-19 pandemic on several aspects of breast-cancer management, and the subsequent modifications adopted by clinicians, scientific groups, and governments as a response to the novel conditions. Screening and diagnosis, as well as breast-cancer treatment paths—especially surgical interventions—were the most affected domains, while patients’ psychological burden also emerged as a notable consequence. The aftermath of diagnostic and surgical delays is yet to be assessed, while the treatment alterations and the introduction of new therapeutic schemes might signify the opening of a novel era in breast-cancer management. Full article

(This article belongs to the Special Issue The Challenges of COVID-19 with Obesity-Related Cancers)

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24 pages, 944 KiB

Open AccessReview

Management of Hematologic Malignancies in the Era of COVID-19 Pandemic: Pathogenetic Mechanisms, Impact of Obesity, Perspectives, and Challenges

by Dimitrios Tsilingiris, Narjes Nasiri-Ansari, Nikolaos Spyrou, Faidon Magkos and Maria Dalamaga

Cancers 2022, 14(10), 2494; https://doi.org/10.3390/cancers14102494 - 19 May 2022

Cited by 7 | Viewed by 4146

Abstract

The COVID-19 pandemic brought about an unprecedented societal and healthcare system crisis, considerably affecting healthcare workers and patients, particularly those with chronic diseases. Patients with hematologic malignancies faced a variety of challenges, pertinent to the nature of an underlying hematologic disorder itself as well as its therapy as a risk factor for severe SARS-CoV-2 infection, suboptimal vaccine efficacy and the need for uninterrupted medical observation and continued therapy. Obesity constitutes another factor which was acknowledged since the early days of the pandemic that predisposed people to severe COVID-19, and shares a likely causal link with the pathogenesis of a broad spectrum of hematologic cancers. We review here the epidemiologic and pathogenetic features that obesity and hematologic malignancies share, as well as potential mutual pathophysiological links predisposing people to a more severe SARS-CoV-2 course. Additionally, we attempt to present the existing evidence on the multi-faceted crucial challenges that had to be overcome in this diverse patient group and discuss further unresolved questions and future challenges for the management of hematologic malignancies in the era of COVID-19. Full article

(This article belongs to the Special Issue The Challenges of COVID-19 with Obesity-Related Cancers)

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22 pages, 499 KiB

Open AccessReview

A Narrative Review of the Safety of Anti-COVID-19 Nutraceuticals for Patients with Cancer

by Karlen Stade Bader-Larsen, Elisabeth Anne Larson, Maria Dalamaga and Faidon Magkos

Cancers 2021, 13(23), 6094; https://doi.org/10.3390/cancers13236094 - 03 Dec 2021

Cited by 5 | Viewed by 2675

Abstract

Interest in dietary supplements and their efficacy in treating and preventing disease has increased greatly since the outbreak of the COVID-19 pandemic. Due to the risk of severe COVID-19 in patients with cancer, we conducted a narrative review aiming to better understand the data on the safety of the most efficacious “anti-COVID-19” nutraceuticals for patients with cancer. We conducted a PubMed database search aimed at identifying the most effective nutrients for use against COVID-19. For the identified nutraceuticals, we searched PubMed again regarding their safety for patients with cancer. Fifty-four total records (52 independent studies) were retrieved, pertaining to vitamin D, vitamin C, selenium, omega-3 fatty acids, and zinc. Vitamin D results from 23 articles indicated safe use, but two articles indicated potential harm. All 14 articles for vitamin C and five out of six articles for selenium indicated the safety of use (one study for selenium suggested harm with high-dose supplementation). Results for omega-3 fatty acids (seven articles) and zinc (one article), however, were rather mixed regarding safety. We conclude that vitamin D, vitamin C, and selenium supplements are likely safe or even beneficial at typically recommended doses; however, caution is urged with omega-3 fatty acid supplements, and zinc supplements should likely be avoided. More experimental research is needed, and nutraceutical use by patients with cancer should always be under the supervision of a healthcare team. Full article

(This article belongs to the Special Issue The Challenges of COVID-19 with Obesity-Related Cancers)

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11 pages, 428 KiB

Open AccessReview

Melanoma Management during the COVID-19 Pandemic Emergency: A Literature Review and Single-Center Experience

by Caterina Cariti, Martina Merli, Gianluca Avallone, Marco Rubatto, Elena Marra, Paolo Fava, Virginia Caliendo, Franco Picciotto, Giulio Gualdi, Ignazio Stanganelli, Maria Teresa Fierro, Simone Ribero and Pietro Quaglino

Cancers 2021, 13(23), 6071; https://doi.org/10.3390/cancers13236071 - 02 Dec 2021

Cited by 11 | Viewed by 2005

Abstract

Background: The current COVID-19 pandemic has influenced the modus operandi of all fields of medicine, significantly impacting patients with oncological diseases and multiple comorbidities. Thus, in recent months, the establishment of melanoma management during the emergency has become a major area of interest. In addition to original articles, case reports and specific guidelines for the period have been developed. Purpose: This article aims to evaluate whether melanoma management has been changed by the outbreak of COVID-19, and if so, what the consequences are. We summarized the main issues concerning the screening of suspicious lesions, the diagnosis of primary melanoma, and the management of early-stage and advanced melanomas during the pandemic. Additionally, we report on the experience of our dermatological clinic in northern Italy. Methods: We performed a literature review evaluating articles on melanomas and COVID-19 published in the last two years on PubMed, as well as considering publications by major healthcare organizations. Concerning oncological practice in our center, we collected data on surgical and therapeutic procedures in patients with a melanoma performed during the first months of the pandemic. Conclusions: During the emergency period, the evaluation of suspicious skin lesions was ensured as much as possible. However, the reduced level of access to medical care led to a documented delay in the diagnosis of new melanomas. When detected, the management of early-stage and advanced melanomas was fully guaranteed, whereas the follow-up visits of disease-free patients have been postponed or replaced with a teleconsultation when possible. Full article

(This article belongs to the Special Issue The Challenges of COVID-19 with Obesity-Related Cancers)

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12 pages, 353 KiB

Open AccessReview

The Impact of the COVID-19 Pandemic on Oncology Care and Clinical Trials

by Jennyfa K. Ali and John C. Riches

Cancers 2021, 13(23), 5924; https://doi.org/10.3390/cancers13235924 - 25 Nov 2021

Cited by 20 | Viewed by 2949

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has caused considerable global disruption to clinical practice. This article will review the impact that the pandemic has had on oncology clinical trials. It will assess the effect of the COVID-19 situation on the initial presentation and investigation of patients with suspected cancer. It will also review the impact of the pandemic on the subsequent management of cancer patients, and how clinical trial approval, recruitment, and conduct were affected during the pandemic. An intriguing aspect of the pandemic is that clinical trials investigating treatments for COVID-19 and vaccinations against the causative virus, SARS-CoV-2, have been approved and conducted at an unprecedented speed. In light of this, this review will also discuss the potential that this enhanced regulatory environment could have on the running of oncology clinical trials in the future. Full article

(This article belongs to the Special Issue The Challenges of COVID-19 with Obesity-Related Cancers)

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28 pages, 2886 KiB

Open AccessReview

Charting the Unknown Association of COVID-19 with Thyroid Cancer, Focusing on Differentiated Thyroid Cancer: A Call for Caution

by Maria V. Deligiorgi, Gerasimos Siasos, Lampros Vakkas and Dimitrios T. Trafalis

Cancers 2021, 13(22), 5785; https://doi.org/10.3390/cancers13225785 - 18 Nov 2021

Cited by 7 | Viewed by 2477

Abstract

Background: Conceived of as the “silver lining” of the dark cloud of the coronavirus disease 2019 (COVID-19) pandemic, lessons taught by this catastrophe should be leveraged by medical authorities and policy makers to optimize health care globally. A major lesson is that resilient health systems should absorb sudden shocks incited by overwhelming health emergencies without compromising the continuum of care of chronic diseases, especially of cancer. Methods: The present review dissects the association between COVID-19 and thyroid cancer (TC), especially with differentiated TC (DTC), focusing on available data, knowledge gaps, current challenges, and future perspectives. Results: Obesity has been incriminated in terms of both COVID-19 severity and a rising incidence of TC, especially of DTC. The current conceptualization of the pathophysiological landscape of COVID-19–(D)TC association implicates an interplay between obesity, inflammation, immunity, and oxidative stress. Whether COVID-19 could aggravate the health burden posed by (D)TC or vice versa has yet to be clarified. Improved understanding and harnessing of the pathophysiological landscape of the COVID-19–(D)TC association will empower a mechanism-guided, safe, evidence-based, and risk-stratified management of (D)TC in the COVID-19 era and beyond. Conclusion: A multidisciplinary patient-centered decision-making will ensure high-quality (D)TC care for patients, with or without COVID-19. Full article

(This article belongs to the Special Issue The Challenges of COVID-19 with Obesity-Related Cancers)

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Other

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11 pages, 534 KiB

Open AccessPerspective

Where Enhanced Recovery after Surgery (ERAS) Protocols Meet the Three Major Current Pandemics: COVID-19, Obesity and Malignancy

by Anastasia Prodromidou, Aristotelis-Marios Koulakmanidis, Dimitrios Haidopoulos, Gregg Nelson, Alexandros Rodolakis and Nikolaos Thomakos

Cancers 2022, 14(7), 1660; https://doi.org/10.3390/cancers14071660 - 25 Mar 2022

Cited by 4 | Viewed by 1872

Abstract

The outbreak of the SARS-CoV-2 (COVID-19) pandemic has transformed the provision of medical services for both patients that receive care for COVID-19 and for those that need care either for benign diseases, including obesity, or for malignancies, such as gynecological cancer. In this perspective article, we focus on the association among three major worldwide health issues and how ERAS protocols can potentially provide optimal management of patients with obesity and malignancy during the COVID-19 pandemic, with special attention to patients who required surgery for gynecologic oncology. A thorough search of the literature on the respective topics was performed. Patients with malignancy and obesity presented with increased vulnerability to COVID-19 infection. However, the management of their disease should not be withheld. Protective measures should be established to reduce exposure of patients with oncological diseases to SARS-CoV-2 while simultaneously enabling their access to vaccination. Since ERAS protocols have proved to be efficient in many surgical fields, including gynecologic oncology, general surgery, and orthopedics, we strongly believe that ERAS protocols may play a significant role in this effort. The end of the COVID-19 pandemic cannot be accurately predicted. Nevertheless, we have to ensure the appropriate and efficient management of certain groups of patients. Full article

(This article belongs to the Special Issue The Challenges of COVID-19 with Obesity-Related Cancers)

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11 pages, 710 KiB

Open AccessSystematic Review

Colorectal Surgery in the COVID-19 Era: A Systematic Review and Meta-Analysis

by Nikolaos Pararas, Anastasia Pikouli, Dimitrios Papaconstantinou, Georgios Bagias, Constantinos Nastos, Andreas Pikoulis, Dionysios Dellaportas, Panagis Lykoudis and Emmanouil Pikoulis

Cancers 2022, 14(5), 1229; https://doi.org/10.3390/cancers14051229 - 27 Feb 2022

Cited by 8 | Viewed by 2053

Abstract

(1) Background: To determine the impact of the COVID-19 pandemic in the management of colorectal cancer patients requiring surgery and to examine whether the restructuring of healthcare systems led to cancer stage upshifting or adverse treatment outcomes; (2) Methods: A systematic literature search of the MedLine, Scopus, Web of Science, and CNKI databases was performed (PROSPERO ID: CRD42021288432). Data were summarized as odds ratios (OR) or weighted mean differences (WMDs) with 95% confidence intervals (95% CIs); (3) Results: Ten studies were examined, including 26,808 patients. The number of patients presenting with metastases during the pandemic was significantly increased (OR 1.65, 95% CI 1.02–2.67, p = 0.04), with no differences regarding the extent of the primary tumor (T) and nodal (N) status. Patients were more likely to have undergone neoadjuvant therapy (OR 1.22, 95% CI 1.09–1.37, p < 0.001), while emergency presentations (OR 1.74, 95% CI 1.07–2.84, p = 0.03) and palliative surgeries (OR 1.95, 95% CI 1.13–3.36, p = 0.02) were more frequent during the pandemic. There was no significant difference recorded in terms of postoperative morbidity; (4) Conclusions: Patients during the pandemic were more likely to undergo palliative interventions or receive neoadjuvant treatment. Full article

(This article belongs to the Special Issue The Challenges of COVID-19 with Obesity-Related Cancers)

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12 pages, 2211 KiB

Open AccessHypothesis

Autophagy: The Potential Link between SARS-CoV-2 and Cancer

by Parham Habibzadeh, Hassan Dastsooz, Mehdi Eshraghi, Marek J. Łos, Daniel J. Klionsky and Saeid Ghavami

Cancers 2021, 13(22), 5721; https://doi.org/10.3390/cancers13225721 - 16 Nov 2021

Cited by 17 | Viewed by 13992

Abstract

COVID-19 infection survivors suffer from a constellation of symptoms referred to as post-acute COVID-19 syndrome. However, in the wake of recent evidence highlighting the long-term persistence of SARS-CoV-2 antigens in tissues and emerging information regarding the interaction between SARS-CoV-2 proteins and various components of the host cell macroautophagy/autophagy machinery, the unforeseen long-term consequences of this infection, such as increased risk of malignancies, should be explored. Although SARS-CoV-2 is not considered an oncogenic virus, the possibility of increased risk of cancer among COVID-19 survivors cannot be ruled out. Herein, we provide an overview of the possible mechanisms leading to cancer development, particularly obesity-related cancers (e.g., colorectal cancer), resulting from defects in autophagy and the blockade of the autophagic flux, and also immune escape in COVID-19 survivors. We also highlight the potential long-term implications of COVID-19 infection in the prognosis of patients with cancer and their response to different cancer treatments. Finally, we consider future directions for further investigations on this matter. Full article

(This article belongs to the Special Issue The Challenges of COVID-19 with Obesity-Related Cancers)

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