Morphogenesis of Changes in the Structural Components of the Skin in Cancer Patients with COVID-19 in Older Age Groups

Background: Immunosuppression caused by cancer or cytotoxic drugs, aging, and comorbidities makes cancer patients not only more susceptible to COVID-19, but also more likely to progress to a severe form and increase the incidence of serious complications. The epitheliotropy of this virus is of interest to the study of skin changes and the degree of their manifestation in patients with malignant neoplasms. In this regard, the aim of our research was to study the morphogenesis of changes in the structural components of the skin in cancer patients with COVID-19.
Methods and Results: We examined the features of morpho-functional changes in skin components in 80 cancer patients who died in Kursk and the Kursk region for the period January 2021–February 2022. Group 1 included cancer patients with no history of COVID-19, whose cause of death was peritonitis due to colorectal cancer; Group 2 included cancer patients whose cause of death was viral pneumonia caused by COVID-19. Each group was further divided by sex and age. The research material was skin fragments. The results of histological and morphometric studies of the skin show that lymphocytic infiltration was typical for all age subgroups of cancer patients with COVID-19, which had higher numbers of lymphocytes per 100 cells than cancer patients without COVID-19. Infiltrative-inflammatory changes are observed in the skin, the severity of which depends on the patient's age. For the age subgroup of 76-85 years without COVID-19, a more pronounced increase in the ratio of the reticular layer to the papillary layer was characteristic, due to a decrease in the thickness of the papillary layer. Pronounced thickening of the papillary layer was found in all age subgroups of cancer patients with COVID-19, compared with the same age subgroups in cancer patients without COVID-19.
Conclusion: It is possible to predict more frequent skin manifestations in cancer patients who have had a new COVID-19 infection, the mechanism of which is mainly due to changes in specific leukocytes, T-lymphocytes, and macrophages and their infiltration of skin tissues.