Immune checkpoint inhibition in COVID-19: risks and benefits.
INTRODUCTION
Immune checkpoint inhibition (ICI) is a novel cancer immunotherapy, which is administered in patients with metastatic, refractory, or relapsed solid cancer types. Since the initiation of the Coronavirus Disease 2019 (COVID-19) pandemic, many studies have reported a higher severity and mortality rate of COVID-19 among patients with cancer in general.


AREAS COVERED
The immunomodulatory effects of ICI can modify the patients' immune system function in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. There is controversy over whether the severity of COVID-19 in cancer patients who previously received ICI compared to other patients with cancer has increased. There is evidence that the upregulation of immune checkpoint molecules in T cells, lymphopenia, and inflammatory cytokine secretion are associated with the severity of COVID-19 symptoms.


EXPERT OPINION
ICI can interrupt the T cell exhaustion and depletion by interrupting the inhibitory signaling of checkpoint molecules in T cells, and augments the immune system response in COVID-19 patients with lymphopenia. However, ICI may also increase the risk of cytokine release syndrome. ICI can be considered not only as a cancer immunotherapy but also as immunotherapy in COVID-19. More studies are needed to assess the safety of ICI in COVID-19 patients with or without cancer.
['Pezeshki|Parmida Sadat|PS|0000-0003-2817-4734', 'Rezaei|Nima|N|']
D000086382:COVID-19 D006801:Humans D000082082:Immune Checkpoint Inhibitors D058873:Pandemics D018570:Risk Assessment D000086402:SARS-CoV-2
immune Checkpoint Inhibition COVID-19 immunotherapy severe acute respiratory syndrome coronavirus 2 lymphopenia cytokine release syndrome