Fig. 5: SARS-CoV-2 infection increases cancer progression, metastasis to lungs and mortality.

a, Quantification of HER2⁺ cells across three lung sections in C57BL6/J MMTV-Her2 mouse lungs at 28 dpi with MA10 SARS-CoV-2 (n = 6) or PBS control (n = 7). b,c, Quantification of HER2⁺ cells and percentage of Ki67⁺ HER2⁺ cells at 3 dpi and 9 dpi with MA10 in the lungs of FVB MMTV-Her2 mice (n = 3 PBS at 3 dpi and n = 4 at 9 dpi) (b) and comparing MMTV-Her2 mice without (WT) or with Il6 knockout (n = 4 per group) (c). Significance was determined by two-tailed Student’s t-test (a,c). For b, we applied a negative binomial model for HER2⁺ cells per field comparing 9 dpi and PBS control (to accommodate the potential overdispersion); for HER2⁺Ki67⁺ cells per field, we determined whether cells per field in infected groups were significantly higher than 0 (all PBS samples were 0) using a negative binomial model. All replicates are biological. d,e, Epidemiological studies. d, Analyses from the UK Biobank examining the association between a SARS-CoV-2 test being positive or negative and the risk of all-cause, non-COVID-19 and cancer-related mortality in cancer survivors with cancer diagnoses more than 5 (red) or 10 (black) years before the start of the COVID-19 pandemic. The analyses compared mortality risks between positive-test and negative-test participants, using censoring dates for death events from 1 December 2020 to 31 December 2022. e, Analyses from the Flatiron Health database evaluating the hazard ratio for the risk of progression to metastatic lung disease among patients with breast cancer who developed COVID-19 disease versus those who did not, adjusted for age, race and ethnicity (red) and multivariate analyses after also including co-morbidities, breast cancer subtype (for example, ER status) and other potential confounding factors (blue). All box-and-whisker plots are shown as maximum value (top line), median (middle line) and minimum (bottom line) with all data points shown as dots.

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