Tamoxifen in breast cancer survivors with COVID 19: stop or go?

Excerpt

The COVID 19 pandemic threatens human health in many ways. Although vaccines that have completed phase 3 trials are being used today, it is estimated that the risk of infection will continue for a while. Many people will continue to suffer from severe COVID 19 disease in this process, and some of these patients will unfortunately die. The most common known cause of death in COVID 19 infection is acute respiratory distress syndrome (ARDS) [1]. It is known that advanced age, obesity, chronic diseases such as diabetes mellitus, hypertension increase the mortality of COVID 19 [1]. There is also evidence that COVID 19 infection is more fatal in patients with cancer. We experienced an increased risk of venous thromboembolism (VTE) in viral infections in the H1N1 pandemic (5.9%). However, in COVID 19 infection, compared to H1N1, VTE was found much more frequently (15–45%) [1]. Although it is not known precisely by which mechanism the risk of VTE increases in COVID 19, it is thought that increased systemic inflammation and endothelial damage have an essential role in this issue [1]. The risk of VTE is increased not only in hospitalized patients but also in outpatient COVID 19 cases. A meta-analysis showed that among patients with COVID 19, the mortality risk was significantly increased in patients with VTE compared to those without (OR 1.74; 95% CI 1.01–2.98) [1]. Several groups recommended low molecular weight heparin (LMWH) for every COVID patient if there are no contraindications, but there is no clear consensus on this issue. …