Title : Addressing the intersection of long COVID, inflammation, and cancer in the public health care sector of South Africa
Abstract:
Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), has emerged as a significant public health concern globally. Characterized by persistent symptoms such as fatigue, chronic inflammation, and immune dysregulation, Long COVID is believed to increase the risk of non-communicable diseases, including cancer. Chronic inflammation is a well-established risk factor for cancer development, raising concerns about Long COVID’s long-term effects on cancer incidence, particularly in countries like South Africa, where the public health system faces significant resource constraints and a high burden of comorbid conditions such as HIV/AIDS and tuberculosis. This scoping review aims to explore the potential link between Long COVID and cancer risk, with specific focus within the South African public health care sector.
A scoping review was conducted using PRISMA-ScR guidelines to search academic databases (Cochrane, PubMed, Scopus, and Google Scholar)to identify peer-reviewed studies, reports, and reviews on Long COVID, chronic inflammation, cancer risk, and South Africa’s healthcare system. Studies examining the relationship between persistent inflammation, immune dysregulation, and cancer in populations affected by COVID-19 were included. In addition, we examined literature on Long COVID’s impact on public health systems in low- and middle-income countries; South Africa's cancer burden, healthcare infrastructure, and comorbidities like HIV/AIDS and tuberculosis to assess how these factors intersect with Long COVID.
The initial findings of the review found that Long COVID is associated with prolonged immune activation and chronic inflammation, which are known risk factors for cancer. In the South African context, high rates of comorbidities such as HIV and tuberculosis, which also promote chronic inflammation, could exacerbate the long-term cancer risk posed by Long COVID. Resource constraints in South Africa’s public health system, particularly in cancer diagnosis and treatment, may result in delayed detection and poorer outcomes. Vulnerable populations, such as those living with HIV, are particularly at risk due to immune dysregulation and pre-existing cancer susceptibilities.
Long COVID could significantly contribute to the future cancer burden in South Africa, particularly through chronic inflammation and immune dysregulation. Strengthening cancer screening, improving management of chronic conditions, and maintaining adequate resource allocation for oncology services are critical for mitigating this potential public health challenge. Further research is necessary to quantify Long COVID’s long-term effects on cancer risk in this context.
