Treatment of Non-Muscle Invasive Bladder Cancer with BCG: Implications for the SARS CoV-2 Pandemic

Abstract

Background: Hypotheses defend BCG being able to have an impact on the course of COVID-19 disease, decreasing the rate of infections and their severity. Objective: To determine if the incidence and severity of COVID-19 are less in patients who receive adjuvant treatment with intravesical BCG for non-muscle invasive bladder cancer and if the number of instillations are influential. Methods: All the participants treated with intravesical BCG between January and June-2020 were analysed, researching if they had been infected, and comparing them with the infection rate in the general reference population of our Hospital. Ethical Aspects: The Healthcare Ethics Committee of the Hospital approved the study and informed consent forms were delivered to patients treated with BCG in order to authorize the use of their data in this study. Statistical Analysis: OpenEpi (Link) statistical analysis was carried out by means of 2×2 tables applying the chi-square statistic and Fisher test for qualitative variables. Results: 117 patients, 23 women (19.7%) and 94 men (80.3%), received treatment with BCG. The mean age was 72.12 years; all ≥50 years. Seven in induction phase, 6 weeks, and 110 in 1-year maintenance, 3 weeks to 3, 6 and 12 months, excluding those that had <4 instillations. Three patients (2.56%) were infected with moderate disease that required admission to the ward. None in the Intensive Care Unit. In the general population, 8558 (5.7 %) were infected. 2015 (1.35%) required admission to the ward and 185 (0.12%) in the Intensive Care Unit. There are no statistically significant differences in the infection rate. Neither was there any in the incidence of moderate or severe disease nor in the incidence of disease between the different phases of the intravesical treatment. Conclusion: We have not been able to demonstrate that intravesical BCG impacts the incidence rate or the severity of COVID-19.