An Asian man sits in a hospital exam chair, with an IV in his right arm.
During the peak of COVID-19 in 2020, a group of MCC scientists and doctors wanted to figure out why some cancer patients who had COVID-19 continued to get very sick—even after they tested negative. Photo/Freepik.

MCC research finds COVID-19 can hide in cancer patients, and may affect their treatment

The Masonic Cancer Center, University of Minnesota, is dedicated to answering tough questions about many different health challenges facing Minnesotans, especially when those health challenges affect Minnesotans who currently have or who have had cancer. During the peak of COVID-19 in 2020, a group of our scientists and doctors wanted to figure out why some cancer patients who had COVID-19 continued to get very sick—even after they tested negative. 

The research team was especially concerned about cancer patients who got COVID-19 and then developed strong inflammatory reactions that looked a lot like autoimmune diseases. So, the research team decided to take a closer look at three patients who had cancer and received transplant-based treatments, all of whom needed hospital care after severe COVID-19 infections. What they discovered was published in iScience.

What did we discover?

  1. COVID-19 stayed in their gut. Even when nose or throat tests were negative, sometimes up to six weeks later, the virus was still alive in the lining of their intestines. This showed us the virus can hide in places other than the nose.
  2. They had inflammation and tissue damage. Because the virus stayed in the gut, it caused the body to send immune cells there. This made inflammation worse and damaged the tissue around it.
  3. A specific marker, SERPINA1, was high. Our research team found a protein named SERPINA1—also called alpha-1 antitrypsin—that stayed high in these patients. It seemed to go along with the inflammation and tissue injury.

Why this matters to us

At MCC, we care deeply about helping patients safely receive cancer treatments, especially complex ones like transplants. Based on the findings regarding COVID-19 in some of our cancer patients, our research suggests:

  • Patients may need gut tissue tests before certain cancer treatments.
  • The marker SERPINA1 could help doctors predict who might have more inflammation.
  • If doctors know a patient has high SERPINA1, they might watch them more closely before and during treatment.

What our leaders are saying

Justin Hwang, PhD, a lead researcher at MCC, shared: “COVID-19 can persist in gastrointestinal tissue, and this may be associated with inflammation and poor patient outcomes during transplantation.”

Emil Lou, MD, PhD, a gastrointestinal oncologist and an MCC researcher, added: “We learned that the virus lasted longer in the intestines than predicted. More study is needed to see if this links to Long COVID or other complications in cancer patients.”

What’s next?

  • Our teams are working to study a larger group of cancer patients who had COVID-19.
  • We want to see if SERPINA1 and gut inflammation connect to other complications.
  • Our goal is to create better ways to decide who can safely go forward with cancer treatments.

A big part of what we do is striving to make cancer care smarter and safer. This discovery helps us better understand how COVID-19 can affect treatment outcomes, and why some cancer patients may need closer monitoring before and during therapies.

This study was supported by Mrs. Hinda Litman and the Litman Family Fund for Cancer Research, the American Cancer Society, a University of Minnesota Data Science Initiative (DSI) Seed Grant, Friends and family of Gayle Huntington, the Mu Sigma Chapter of the Phi Gamma Delta Fraternity, University of Minnesota (FIJI), Dick and Lynnae Koats, Ms. Patricia Johnson and the Love Like Laurie Legacy. 

A version of this article was originally published online by Ezra Xiong for the University of Minnesota Medical School.