FAQs on COVID-19 and Kidney Cancer

A: In most patients COVID-19 infection is minor, but in those admitted to hospital there is often signs of renal damage and 1 in 5 patients admitted to ITU with COVID-19 develop renal failure requiring dialysis support.

A: If an intermediate risk level patient is otherwise fit and healthy, kidney cancer surgery can proceed as planned. It is recommended to not postpone surgery.

A: The recommendation is, it is possible to delay for 3-6 months.

According to the infection severity, medical treatments for metastasised kidney cancer should be paused until symptoms improve and the acute phase of the infection is over.

In stable disease situations, re-staging procedures might be postponed to a later time after cure of COVID-19. In severe COVID-19 infections, specific medications for metastasized kidney cancer may potentially be harmful and need to be postponed until the infection has improved. It is unlikely that patients with kidney cancer would still be receiving immune checkpoint inhibitors during this phase of COVID-19. However, careful consideration should be given to the prospect of delaying treatment if  patients are showing flu-like symptoms at the time of intended immune checkpoint inhibitor treatment. Adverse effects among patients who receive immune checkpoint inhibitors (such as for severe myocarditis and pneumonitis) are more challenging to diagnose and might not be treated promptly, which might affect their survival.

The risk of catching COVID-19 is not affected by a past history of kidney cancer. However, if you are currently on systemic therapy for metastatic disease, you are likely to have an have a suppressed immune system increasing your risk of developing clinical sysmptoms. There is a risk because of immunosuppression with e.g. corticosteroids, progressive cancer situation, immune-oncologic therapy and mainly applicable to metastasised patients who receive systemic therapies. The general risk of getting an infection with clinical symptoms is higher than in the healthy population.

Another potential major risk for patients with cancer is the inability to receive necessary medical services, in terms of getting to a hospital or normal medical care.

If you are otherwise healthy, then your risk of catching COVID-19 would be similar to someone with two kidneys. Keep in mind, that every person is unique though and other factors may increase the risk of being infected with COVID-19. If you have concerns, contact your doctor or medical team. Most kidney cancer patients do not have chronic (long-term) kidney disease. For patients with chronic kidney disease, it is extra important to follow the social distancing guidelines as these patients have an increased risk to develop complications as a result of COVID-19.

Whilst most patients have mild symptoms and don’t experience a deterioration in renal function, about 1 in 3 patients admitted to hospital show signs of kidney damage. There may be a decline in kidney function (GFR-glomerular filtration rate) in severely affected patients. The virus can attach to renal cells causing direct damage, but it is more likely to be related to either a lack of oxygen in the blood which damages kidney function or the presence of small clots in the bloodstream which can clog the smallest blood vessels in the kidney and impair function. The long-term effects on kidneys and kidney function in survivors of COVID-19 are not yet known at this time as COVID-19 is a new virus and doctors are still learning about the virus.

If you are otherwise healthy, then your risk of catching COVID-19 would be similar to someone with two kidneys. Keep in mind, that every person is unique though and other factors may increase the risk of being infected with COVID-19. If you have concerns, contact your doctor or medical team. Most kidney cancer patients do not have chronic (long-term) kidney disease. Patients with chronic kidney disease are advised to follow the social distancing guidelines as these patients have an increased risk to develop complications as a result of COVID-19.

It is always best to avoid emergency dialysis. Talk to your kidney doctor (nephrologist) to safely plan a treatment session and appropriate counseling. If it cannot be avoided, then contact your nephrologist and the local dialysis centre. They will do all they can to help you.