Thyroid Cancer Coverage from Every Angle
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Prevalence of COVID-19 in Patients With Thyroid Cancer: View From Italian Referral Center

By: Sarah Campen, PharmD
Posted: Wednesday, March 24, 2021

COVID-19 infection does not seem to be more frequent in patients with thyroid cancer than in the general population, concluded a single-center Italian study published in Endocrine. However, a relatively higher prevalence of COVID-19 was observed in a subset of patients with thyroid cancer who were treated with multikinase inhibitors, posing a problematic clinical question: Does SARS-Cov-2 infection require a reduced dosage or suspension of multikinase inhibitor therapy?

“In cases of more severe COVID-19, an accurate evaluation from a multidisciplinary team would consider risks and benefits in taking the decision to continue or stop multikinase inhibitor treatment,” stated Rossella Elisei, MD, of the University of Pisa, Italy, and colleagues.

This study evaluated 1,464 patients with persistent thyroid cancer who were seen at a thyroid disease referral center over 6 months from March to September 2020. It included 67 patients who were taking multikinase inhibitors and 1,397 under active surveillance for persistent but stable disease. During the clinical evaluation, all patients were specifically questioned regarding their history of SARS-Cov-2 infection.

SARS-Cov-2 infection was identified in four patients (0.3%) with thyroid cancer: three under active surveillance and one treated with a multikinase inhibitor. This patient received vandetanib for metastatic medullary thyroid cancer when he presented with severe fatigue and dyspnea upon light physical activity. His course of COVID-19 was ultimately mild, and he received exclusively supportive care. After a multidisciplinary consultation, the authors decided against the discontinuation of vandetanib. After 2 months, the patient no longer had any signs of active infection, and his metastatic disease was stable.

Disclosure: The authors reported no conflicts of interest.

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