Risk factors associated with an immune response, microbiome / viroma and metabolomics in determining outcome of infection by the new Coronavirus (SARS-CoV-2) in cancer patients

Abstract

From December 2019, an outbreak caused by a new virus identified as SARS-CoV-2 has started in Wuhan, Hubei province, China. Facing an alarming advance for several countries besides China, on March 11, 2020, the World Health Organization decreed that a disease caused by SARS-CoV-2 (COVID-19) is a pandemic. The behavior of infection in immunocompromised patients has not been studied much. However, like the other respiratory viruses that affect this population, the infection can cause serious complications such as infection of the lower respiratory tract (ITRI), bronchiolitis obliterans (BO) and even death. Objectives: Determination of risk factors, immune response and microbiome and identification of proteins and metabolites during the progress of infection by the new Coronavirus (SARS-CoV-2) in hematopoietic cell transplant (HCT)recipients, hematological neoplasms or solid tumors. Materials and methods: The present study is an observational, prospective cohort study focusing on SARS-CoV-2 infections in HCT recipients, hematological neoplasms and patients with solid tumors; in addition to the change in the metabolomic profile due to the interaction caused by the infectious-tumor process. All of these patients should receive care at the A.C.Camargo Cancer Center (ACCCC), São Paulo, Brazil. Conclusion: Determination of the interaction between clinical predictors, composition and dynamics of the nasal and intestinal microbiota, the host's cellular immune response and identification of proteins and metabolites, can contribute to the understanding of the risk factors that lead to progression to death among cancer patients diagnosed with a COVID-19. In addition, in the near future, it can substantiate the strategy for managing SARS-CoV-2 infection by identifying the patients at greatest risk for developing the most severe conditions of the disease. (AU)