COVID-19 and Cancer

People with cancer may face higher risks from contagious (spreadable) illnesses, including COVID-19. That’s because cancer and its treatments can weaken their immune system. This makes it harder to fight off infections. The virus can also have more serious side effects in people with certain types of cancer.

Learn about COVID-19, how the virus can affect people with cancer, how to protect yourself and loved ones, and what to know about vaccines and staying safe.

What is COVID-19?

COVID-19 (coronavirus disease 2019) is the name of the illness caused by a type of virus called a coronavirus. Several types of coronaviruses can infect humans. Some can cause more serious illnesses than others. The coronavirus that causes COVID-19 is SARS-CoV-2.

Both adults and children can get COVID-19, even more than once. It's important to know that anyone with COVID-19 can spread it, even if they don’t have any symptoms.

Infection with any virus, including the COVID-19 virus, causes the body’s immune system to respond and try to get rid of the infection. Your immune system normally also helps to protect you from severe illness and from getting infected again with the same virus.

Some cancers and their treatments can weaken your immune system, making it easier for infections to get in and harder for the body to fight them off.

COVID-19 variants

Over time, viruses such as COVID-19 can change or mutate, resulting in new variants of the virus. These variants or strains might act slightly differently than the original virus. For example, they might spread more easily or be more resistant to known treatments or vaccines. They may have slightly different symptoms, too.

Symptoms of COVID-19

People with COVID-19 can have a wide range of symptoms, ranging from mild to severe. Some people might have no symptoms at all.

Acute COVID-19 infection

An acute infection happens within a short amount of time after a person is exposed to COVID-19. Symptoms can appear 2-14 days after exposure to the virus.

The most common symptoms of COVID-19 are:

• Fever or chills
• Cough
• Shortness of breath
• Muscle aches and pains
• Sore throat
• Loss of smell or taste
• Stuffy or runny nose
• Sore throat
• Feeling very tired
• Headache
• Diarrhea
• Nausea or vomiting

If you have cancer and have any of the above symptoms that get worse or don’t go away, contact your cancer care team. If you are being treated for your cancer, ask your care team if you need to delay any treatments based on your symptoms.

COVID-19 can also sometimes cause serious signs and symptoms that need medical attention right away:

• Trouble breathing
• Constant pain or heaviness in the chest
• Confusion or being hard to wake up
• Pale, gray, or blue-colored skin, lips, or nails, depending on skin tone

Whether you have cancer or not, if you have any of these serious symptoms, get medical attention right away.

People who have certain medical conditions, including cancer, are at a higher risk for severe COVID symptoms. A few risk factors for having more serious signs and symptoms include:

• Being older
• Having a weakened immune system
• Having excess body weight (overweight or obesity)
• Smoking, now or in the past
• Having certain types of cancer, such as leukemia, lymphoma, or lung cancer

Long COVID

Some people who’ve been infected with COVID-19 might have long-term effects. These might be called post-COVID conditions, long COVID, chronic COVID, or long-haul COVID. People who have been reinfected with COVID have a higher risk of developing long COVID.

A person with long COVID can continue to have some of their initial symptoms last longer than usual. Some symptoms may get better or go away completely while others remain a problem for longer periods of time. These symptoms might last weeks, months, or even longer.

Some common symptoms of long COVID include:

• Extreme tiredness that affects your daily life
• Symptoms that worsen after mental or physical effort
• Trouble thinking or concentrating
• Shortness of breath
• Diarrhea

People who are vaccinated against COVID-19 might be less likely to get long COVID than people who aren’t vaccinated, but anyone can develop long COVID.

If you have cancer and have long COVID, be sure to keep your cancer care team updated on your symptoms. Many cancer treatments can have some of the same side effects as the symptoms of long COVID.

For the latest on COVID-19 symptoms, variants, and long COVID, visit the US Centers for Disease Control and Prevention (CDC) website.

COVID-19 in people with cancer

Some people with cancer are at higher risk of serious illness if they get almost any viral infection, including COVID-19. People who were treated for cancer in the past (especially if it was years ago) are less likely to be at higher risk. But the situation for each person is different.

The impact of COVID-19 on people living with cancer is still being studied. So far, research shows:

• Cancer itself and its treatments can increase a person’s risk of getting COVID-19.
• Some people with cancer have higher risks of having severe symptoms of COVID‑19.
• Some people with cancer have a higher risk of needing to be admitted to the hospital, needing to be in the intensive care unit (ICU), and needing mechanical ventilation (being on a ventilator) to help treat COVID-19 and its symptoms.

Which people with cancer are at higher risk from COVID?

It’s very important that people with cancer take steps to lower their risk of infection (see below). This is especially true for:

• People with blood cancers (such as leukemia or lymphoma)
• People getting chemotherapy (chemo), long courses of corticosteroids (steroids), certain types of immunotherapy, or a stem cell or bone marrow transplant
• People living with lung cancer, because the COVID-19 virus often targets the respiratory system
• People who need frequent medical appointments, which can increase their risk of being exposed to COVID-19

If you have questions about COVID-19, remember each person’s situation is different. It's important that people who’ve had cancer talk with a doctor who understands their situation and medical history.

How can I lower my risk of getting COVID-19?

There are several things you can do to help lower your risk of being infected with the COVID-19 virus.

Stay up to date with COVID-19 vaccines

Vaccines are one of the most important ways to help protect against COVID-19.

Several vaccines are available to help protect against COVID-19. Because the COVID-19 virus changes over time, updated versions of the vaccines come out each year, to help protect against the most recent strains of the virus.

The CDC recommends most adults 18 and older stay current with a COVID-19 vaccine. The CDC also advises that parents of children from 6 months to 17 years old should discuss the risks and benefits of the vaccine with their child’s doctor.

Talk with your cancer care team about the vaccine

COVID-19 vaccines are recommended for people with cancer. But if you’re being treated for cancer, there might be times when it makes sense to postpone getting the vaccine for a while, such as if the treatment will severely weaken your immune system. Some cancer treatments might even wipe out your immune system for a while, which might mean you need to get revaccinated later on.

If you’re being treated for cancer, talk to your doctor about your immune status and whether it could affect the best time for you to get the vaccine, as well as what else you can do to help lower your risk of COVID-19 infection.

For more on the COVID-19 vaccine, visit the CDC website.

Talk to your doctor about other medicines to lower your risk

For people who are less likely to get enough protection from COVID-19 vaccines, pemivibart (Pemgarda) can help lower the risk of infection. This medicine is given as an infusion into a vein (IV), typically once every 3 months.

It’s important to note that in people who can get COVID-19 vaccines, this treatment should be used in addition to, not instead of getting the vaccine. Talk to your doctor for more information and to find out whether pemivibart is an option for you.

Lower your risk in other ways

Being vaccinated and taking preventive medicines can help lower your risk, but those actions don’t protect you completely. Even if you’re up to date with vaccines or have had COVID-19 in the past, you can still be infected or reinfected.

Other things you can do to help lower your risk of getting COVID-19, as well as other respiratory infections like the flu, might include:

• Avoiding crowded indoor spaces
• Avoiding close contact with people who are sick
• Wearing a mask when out in public

If you have (or have had) cancer, or if you’re taking care of someone with cancer, talk to the cancer care team about which precautions are right for you. Their recommendations will depend on whether you have a weakened immune system or other risk factors for severe COVID-19.

Learn more ways to protect yourself and others in Infections in People with Cancer.

How is COVID-19 treated?

Not everyone who gets COVID-19 needs to be treated. But treating COVID-19 can be very helpful for some people, especially those who are more likely to get very sick from it. Several different drugs (or combinations of drugs) might be used, depending on how sick a person is, how old they are, and other factors. If needed, these treatments can be used in most people, including people with cancer.

Depending on the drug used, these treatments typically work by:

• Targeting the virus that causes COVID-19.
• Reducing inflammation in the body. Inflammation can lead to some of the more severe symptoms of COVID-19.

Researchers are also studying many other drugs that might help treat COVID-19 or its symptoms.

Questions to ask your health care team about COVID-19

If you have cancer or have had cancer in the past, here are some questions to ask your health care team about COVID-19:

• Am I at higher risk of serious illness if I get COVID-19? Why or why not?
• Should I get the COVID-19 vaccine? If so, should I get it now, or should I wait?
• Could my cancer or its treatment affect how well the vaccine works for me?
• Should I take any other steps to lower my risk of getting COVID, even if I’ve had the vaccine? If so, what would these be?
• What about the people taking care of me? Should they get the COVID vaccine and/or take other steps to lower their risk?
• What should I do if I have symptoms that might be from COVID-19?
• If I get sick from COVID-19, will it affect my treatment or the outlook (prognosis) of my cancer?

Remember, each person’s cancer, treatment, and situation can be different, so the answers might not be the same for everyone.

Where can I learn more about COVID-19?

For other sources of information on COVID-19, including more detailed answers to some common questions, visit the following websites:

• Centers for Disease Control and Prevention (CDC)
• Food and Drug Administration (FDA)
• National Cancer Institute (NCI)
• World Health Organization (WHO)