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INTRODUCTION
The year 2020 was marked by the appearance of the current COVID-19 pandemic that has affected millions
of people around the world and has challenged the health care systems of all countries.

COVID-19 is a systemic viral disease that specifically compromises the respiratory system and presents
with different levels of severity, which depends mainly on the immune response of the host. As in any
infectious disease, patients with cancer are a particularly vulnerable population against COVID-19, and
their need for continuous care and regular contact with the hospital environment puts them at a risk
of COVID-19 contagion. On the other hand, the degree of respiratory compromise due to the cancer
itself is an additional factor of poor prognosis if they are infected. Also, chemotherapy and specific
immunotherapeutic drugs may affect the immunological state of the patient and the outcome of a viral
infection. The care of these patients in the current epidemiological situation represents a challenge for
professionals and institutions, given the limited experience generated in the pandemic. In this article, we
summarize the existing evidence in the literature on COVID-19 infection in patients with lung cancer and
highlight aspects that we consider most relevant in this clinical setting.

SARS COV-2
SARS COV-2 is an RNA virus belonging to the family Coronaviridae. This group of viruses can cause
infection in humans and animals with different levels of severity. They are usually seasonal, predominant in
[1]
winter, and can affect a wide variety of animals . In December 2019, a new coronavirus called severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) triggered an outbreak that caused a global pandemic,
which we suffer to date.

The virus spread worldwide very fast. The main transmission medium is thought to be person-to-person
[2]
respiratory transmission by respiratory droplets when close contact happens. Some environmental
[3]
factors may have contributed to rapid spreading of SARS-CoV-2, for example Xie et al. , described that
low temperatures, especially those below 3 °C contributed to more successful viral transmission in a linear
regression model estimated on the basis of the cases and climate conditions in 122 Chinese cities. Air
[4]
pollution has also been assumed to be associated with higher transmission rates. Coccia published an
article showing that cities with higher pollution rates and lower wind speeds had more COVID-19 cases in
the first few months of the pandemic outbreak in Italy, and prevention strategies were also discussed in the
[4,5]
article . Other research findings also supported the association between SARS-CoV-2 and climate factors
[6]
[7]
such as temperature, wind speed or solar radiation and air pollutants . The most frequent symptoms of
SARS-CoV-2 infection are fever, cough, dyspnoea, ageusia, and myalgia. Some patients with COVID-19
have serious complications including acute respiratory distress syndrome, severe pneumonia, acute kidney
failure, septic shock, and neurological and thrombotic dysfunction . According to data provided by the
[7]
European Center for Disease Prevention and Control, up to 18% of patients admitted to hospitals require
admission to an intensive care unit .
[8]

There are many ongoing clinical trials that are investigating potential treatments for COVID-19. The
controlled, open-label Randomized Evaluation of Covid-19 Therapy (RECOVERY) trial demonstrated
the possible benefit of dexamethasone, especially the less need for invasive mechanical ventilation and the
[9]
lower mortality of critically ill patients in need of oxygen supply , because of which it was recommended
[10]
by the National Institute of Health in the United States . Clinical trials with Remdesivir have shown a
[11]
decrease in recovery time in hospitalized patients with lower respiratory tract infections and a benefit
in the clinical status of patients . Remdesivir has been approved by the United States Food and Drug
[12]
Administration for use in adult and pediatric patients 12 years of age and older and weighing at least 40
[13]
kilograms for the treatment of COVID-19 requiring hospitalization . Hydroxychloroquine, holding