1 Liang W

Guan W

Chen R

et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China.

1 Liang W

Guan W

Chen R

et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China.

First, the data in the Comment by Liang and colleaguesshowed a higher percentage of patients with cancer in the COVID-19 cohort than in the overall population. However, this observation is not sufficient to conclude that patients with cancer had a higher risk of COVID-19. The incidence of COVID-19 in patients with cancer would be more informative in assessing whether or not patients with cancer have an increased risk of COVID-19. Second, we reviewed the cancer history of the 18 individuals discussed in Liang and colleagues' Comment.We are concerned that such a small sample size with a large amount of heterogeneity, presenting as various cancer types with different biological behaviours, highly variable disease courses (from 0–16 years), and diverse treatment strategies, might be filled with contingency and thus not ideally representative of the whole population with cancer. Notably, half of the patients with cancer had a disease course of more than 4 years, indicating that a substantial proportion of these patients might be clinically cured. Therefore, any conclusions that generalise to all patients with cancer should be interpreted with caution. Third, 13 (72%) of 18 patients with cancer had a history of surgical resection; the prolonged effects induced by surgery including immunosuppression should not be neglected. Comparison of patients with COVID-19 and surgical history with and without cancer would be of interest.