Covid-19 Threat in Patients with High-Risk Non-Muscle Invasive Bladder
Cancer Receiving Intravesical BCG Therapy
Abstract
Aim: We evaluated the COVID-19 threat in patients receiving intravesical
BCG therapy which has immunotherapeutic effects and is of vital
importance in most of the individuals with high-risk non-muscle-invasive
bladder cancer (NMIBC) and investigated the need for postponement of
this therapy. Methods: A total of 71 patients, who were diagnosed with
high-risk NMIBC and on intravesical BCG treatment regularly (induction
or maintenance), were enrolled in the study. The patients were
classified into two groups depending on whether they were diagnosed with
COVID-19 during the pandemic period or not. Results: Of 71 patients, 26
underwent a COVID-19 polymerase chain reaction test with clinical
suspicion during the pandemic period. Of these 26 patients, 4 were
diagnosed with COVID-19. Age of the patients, working status
(working/retired), compliance with containment measures against the
pandemic, number of BCG courses, adverse effects after BCG therapy, and
systemic immune-inflammation index, which is an inflammation-related
parameter, were not different between groups (p>0.05).
Neutrophil/lymphocyte ratio was significantly higher in the COVID-19
positive group (p<0.05). COVID-19 positivity was higher in age
groups 50-64 (6.6%) and 65-80 (5.8%) years than that in similar age
groups of the normal population. Conclusion: Every effort should be made
to administer intravesical BCG treatment in high-risk NMIBC patients
even during the pandemic period. However, increased risk of COVID-19
transmission should be kept in mind and protective measures against
COVID-19 for healthcare providers and patients before the procedure
should be taken optimally. The procedure should be postponed in patients
with lymphopenia in recent complete blood count.