The more scientists learn about the novel coronavirus the more complicated the disease it causes appears to be. COVID-19 traditionally presents as a respiratory illness with varying degrees of severity, but a number of unusual cases have prompted medical professionals to think about the deadly virus in a completely different way.
Consider the recent case of a 46-year-old man who presented to ER doctors with complaints of abdominal pain. The patient, whose case was published in the medical journal Cureus, had already been diagnosed with hepatitis C and stage IV mesothelioma, an incurable cancer that primarily affects the lungs. A test was administered and came back positive for COVID-19.
Despite his pre-existing respiratory illness, the patient showed none of the traditional respiratory symptoms of COVID-19, such as cough, fever, shortness of breath, or difficulty breathing. The patient’s primary complaint was abdominal pain.
A CT scan showed swollen lymph nodes and an enlarged mass on the left side of the patient’s chest, but none of these symptoms were consistent with the patient’s pre-existing conditions. Through routine follow-ups prior to the COVID-19 diagnosis, he had shown no signs of worsening cancer or hepatitis symptoms.
The patient was prescribed a drug regimen and eventually discharged, without ever requiring ventilation or oxygenation. He remains well.
A Mysterious Disease
Common sense would tell anyone that a cancer that attacks the lungs would probably worsen any case of COVID-19. In fact, most lung cancer patients who have contracted COVID-19 report serious respiratory problems.
Tumors are known to compromise immune systems, and cancer treatments like chemotherapy and radiation similarly render patients more vulnerable to severe infections. One study of cancer patients who contracted COVID-19 in China showed more than half suffered serious symptoms, and more than a quarter of them eventually died of the illness.
Mesothelioma, too, has been known to complicate outcomes. Past studies have shown that mesothelioma patients who develop COVID-19 often experience lung swelling, water in the lungs, and cellular growth in the lining of the air sacs, all of which can lead to deadly cases of pneumonia.
That this 46-year-old patient with pre-existing conditions did not develop any of the traditional COVID-19 symptoms, especially those common to cancer patients, speaks to how much is still not known about the novel coronavirus.
The authors of the study detailing this unusual case urged doctors to be cognizant of atypical symptoms in patients presenting to emergency rooms.
Have Cancer Cases Really Decreased During the Pandemic?
Cancer patients need to be diligent about protecting themselves from infection by wearing facemasks and practicing social distancing. Moreover, those who are experiencing symptoms — be it for cancer or COVID-19 — should never ignore them.
Fighting cancer is all about early discovery, and doctors remain concerned about undiagnosed individuals not receiving necessary medical care due to fears of coronavirus in hospitals and medical centers.
Recent studies have shown a drop in cancer cases, including mesothelioma, since the beginning of the pandemic. According to one study published in the Journal of the American Medical Association, diagnoses of 6 major types of cancer in the U.S. fell by as much as 46% in the early weeks of the pandemic.
It’s extremely unlikely that this is due to fewer people having cancer. Accordingly, medical experts expect a rise in cancer deaths as a result of patients not seeking medical help sooner.
"While residents have taken to social distancing, cancer does not pause,” Dr. Harvey Kaufman, senior medical director at Quest Diagnostics and the study's lead author, said in a statement. “The delay in diagnosis will likely lead to presentation at more advanced stages and poorer clinical outcomes.”