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. 2020 Mar 27;14:1022. doi: 10.3332/ecancer.2020.1022

Supplementary Table 1. Current studies investigating COVID-19 and cytotoxic chemotherapy.

Study Ref Title Authors Country of study Year Summary of results
[1] The differential diagnosis of pulmonary infiltrates in cancer patients during the outbreak of the 2019 novel coronavirus disease Zhu et al China 2020 COVID-19 complicates the clinical scenario of pulmonary infiltrates in cancer patients. Active treatment against the infection and patient surveillance should be initiated if infectious disease is considered.
[2] Chemotherapy strategy for colorectal cancer under the outbreak of novel coronavirus pneumonia Li et al China 2020 Recommendations based on stage of cancer:
  • Recurrent metastatic colorectal cancer: low-intensity maintenance therapy

  • Patients with tumour changes or higher malignancy still need to receive combined chemotherapy.

  • After radical surgery, given the relatively limited benefits of adjuvant chemotherapy, the intensity and duration of treatment can be reduced.

  • In the face of patients with febrile tumour chemotherapy, it is necessary to analyse the cause of the fever of the patient.

  • Stable disease and good general condition: elect to delay the time of imaging evaluation.

[3] Fatal encephalitis associated with coronavirus OC43 in an immunocompromised child Nilsson et al Sweden 2020 A one-year-old child with pre-B acute lymphoblastic leukaemia (ALL) developed fatal encephalitis associated with human coronavirus OC43 (HCoV-OC43). During chemotherapy the child had a persistent HCoV-OC43 respiratory infection and later developed progressive encephalitis. Cerebrospinal fluid was negative for pathogens including HCoV-OC43, but a brain biopsy was HCoV-OC43-positive.
[4] Recent developments in anti-severe acute respiratory syndrome coronavirus chemotherapy Barnard and Kumaki England 2011 Anti-SARS-CoV therapies recently published from 2007 to 2010 reviewed in this paper and the following compounds have been shown to be active in vitro against the virus:
TNF-α-converting enzyme inhibitor (TAPI-2); IFN-α (B/D, mDEF201 by adenovirus 5 vector, CR3014 humanised monoclonal antibody, recombinant IFN-α2b and type I IFN-β); Interferon inducers (Ampligen and polyinosinic–polycytidylic);
therapeutic antibodies (2978/10, equine anti-SARS-CoV F[ab’] and monoclonal antibody 201); attachment inhibitors (Urtica Dioica lectin and griffithsin); host immune system.
[5] A 3-Year Retrospective Study of the Epidemiology of Acute Respiratory Viral Infections in Pediatric Patients With Cancer Undergoing Chemotherapy Aydin Köker et al Turkey 2019
  • Nasopharyngeal aspirates were analysed in patients younger than 21 years with acute respiratory infections.

  • Coinfection with 2 viruses was present in 20.5% (45/219) of the episodes.

  • Most frequent coinfections of respiratory viruses: 6 cases of HRV+hBoV, 5 of HRV, +AdRV, 4 of PI3+CoV 43, 3 of HRV+CoV 43, 3 of HRV, +IF A/H1N1, 3 of HRV+RSV A/B, and 2 of HRV+EV

  • Detected more often in the months of January (16%) and October (15%) than in the other months

  • Conclusion: no increase in mortality of cancer patients but cause for significant delays to chemotherapy, which might have an indirect impact on patient survival rates.

[6] Frequent Respiratory Viral Infections in Children with Febrile Neutropenia - A Prospective Follow-Up Study Söderman et al Sweden 2016
  • Nasopharyngeal aspirates were collected during 87 episodes of febrile neutropenia in children age 0-18 years

  • No symptoms were apparent in four episodes involving RV and one episode involving HCoV

  • Persistent HCoV with a median follow-up time of 31 days

  • High viral loads were correlated to more symptoms

  • Respiratory viruses play an etiologic role in febrile neutropenia in children receiving treatment for a malignancy.

[7] An Overview of Severe Acute Respiratory Syndrome-Coronavirus (SARS-CoV) 3CL Protease Inhibitors: Peptidomimetics and Small Molecule Chemotherapy Pillaiyar et al USA 2016
  • The paper focuses on on the status of various efficacious anti-SARS-CoV 3CLpro chemotherapies discovered during the last 12 years (2003−2015) from all sources, including laboratory synthetic methods, natural products, and virtual screening.

  • Conclusion: No coronavirus protease inhibitor has yet successfully completed a preclinical development program

[8] Respiratory Viral Infections in Patients With Cancer or Undergoing Hematopoietic Cell Transplant. [Review] Hijano et al Switzerland 2018
  • Clinical manifestations vary significantly depending on the type of virus and the type and degree of immunosuppression.

  • Risk factors associated with prolonged viral shedding can include viral load, use of steroids, and myeloablative conditioning.

  • Mortality associated with coronavirus in HCT recipients was inconclusive. While some studies [9] reported no associations, other studies [10] reported similar mortality rates in HCT recipients to those observed with other viruses such as RSV, influenza virus, and PIV.

[11] Progress in Anti-SARS Coronavirus Chemistry, Biology and Chemotherapy Ghosh et al USA 2007
  • SARS-CoV proteases are attractive targets for the development of antiviral drugs to reduce viral replication and pathogenicity.

  • Glycyrrhizin showed inhibitory activity for SARS-CoV replication but it has high cytotoxicity.

  • HIV protease inhibitor nelfinavir, antihelminthic drug niclosamide and antimalarial agent chloroquine have also showed strong inhibitory activity against SARS-CoV replication.

  • A human lgG1 form of 80R was found to bind the S1 domain of the SARS-CoV S protein (with a higher affinity comparable to that of ACE2 suggesting that the 80R human monoclonal antibody is a useful viral entry inhibitor for SARS treatment.

[12] Alternative screening approaches for discovery of Middle East respiratory syndrome coronavirus inhibitors LaFemina, RL. USA 2014
  • Lopinavir is an HIV protease inhibitor.

  • Lopinavir has been suggested as a low-micromolar inhibitor of MERS-CoV.

  • However, proteases of HIV and coronaviruses fall into different mechanistic classes of proteases.

[13] Acute respiratory viral infections in paediatric cancer patients undergoing chemotherapy Benites et al Brazil 2014
  • Paediatric patients with cancer and acute respiratory infection [14] and/or fever.

  • Coronavirus was identified in 6.8% in the 50 samples of respiratory cases.

  • Human rhinovirus (HRV) was the most common viral pathogen, followed by coronavirus, respiratory syncytial virus (RSV), and metapneumovirus, demonstrating the importance of these pathogens in the studied population.

  • The prevalence of respiratory viruses was relevant in the infectious episode, with no increase in morbidity and mortality. Viral co-detection was frequent in patients with cancer and ARIs.

  • The link of whether severe acute infection was directly related to the type of cancer or viral pathogen was not identified in the study.

[15] Thiopurine analogue inhibitors of severe acute respiratory syndrome-coronavirus papain-like protease, a deubiquitinating and deISGylating enzyme Chen et al Taiwan 2009
  • 6-mercaptopurine (6MP) and 6-thioguanine (6TG) have been used in cancer chemotherapy for treatment of acute lymphoblastic or myeloblastic leukaemia and were found to be specific inhibitors for the SARS coronavirus.

[14] Carbohydrate-binding agents: a potential future cornerstone for the chemotherapy of enveloped viruses? Balzarini, J. Belgium 2007
  • Carbohydrate-binding agents (CBA) may be able to block enveloped viruses other than HIV in their entry process and coronaviruses and influenza viruses are other examples of enveloped viruses that may be highly susceptible to the antiviral action of CBAs.

  • In HIV, glycan deletions in gp120 delays the spread of virus.

  • CBA administration may bring the viral infection under control before glycan deletions occur and the immune system can get involved in the further clearance of the virus.

[16] Molecular biology investigation of respiratory viruses as a factor of infectious complications in hemoblastosis and myelodepression Chebotkevich et al Russia 2006 Only abstract available, article in Russian and not accessible.
  • Communicable respiratory viruses were investigated in 51 patients as a causative factor of infectious complication in hemoblastosis and myelodepression

  • Coronaviruses detected in 13.7%

[17] Synthesis of novel test compounds for antiviral chemotherapy of severe acute respiratory syndrome [18]. [Review] Kesel AJ United Arab Emirates 2005
  • 25 test materials including interferon-inducer

  • Bananin (BN) was an effective inhibitor of SARS-CoV in cell culture.

[19] Induction of Th1 type response by DNA vaccinations with N, M, and E genes against SARS-CoV in mice Huali et al China 2005
  • The M and E are play a role in coronaviral particle assembling. Targeting these agents may lead to immune responses by inducing the production of protective IFN-α.

  • N, M, and E genes may be used as the targets to prevent SARS-CoV infection.

[20] A system of protein target sequences for anti-RNA-viral chemotherapy by a vitamin B6-derived zinc-chelating trioxa-adamantane-triol. Keseal AJ. Germany 2003
  • Bananin acts as zinc (Zn2+) chelator

  • Targets and inhibits zinc finger of HIV-1 RNA-binding nucleocapsid protein p7 (NCp7).

  • Bananin is converted to bananin 5’-monophosphate (BNP) which together with B6RA (vitamin A-vitamin B6 conjugate) and could inhibit infectious virion encapsidation.

  • Targets of BNP and B6RA have shown to be present also in SARS-associated coronavirus making them possible therapeutic candidates.

[21] Coronavirus Pneumonia
Following Autologous Bone
Marrow Transplantation for
Breast Cancer
Folz and Elkordy USA 1999
  • Case report: coronavirus in woman with stage III breast cancer following treatment with hig-dose chemotherapy and autologous bone marrow and stem cell transplant.