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Study Finds Up to 15% of Patients With Cancer Experience 'Long Haul' COVID-19


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New details about patients with cancer who have been infected with COVID-19 have emerged from the large observational OnCOVID study. According to data presented by Alessio Cortellini, MD, and colleagues at the European Society for Medical Oncology (ESMO) Congress 2021 (Abstract 1560O_PR), approximately one in six patients with cancer who have recovered from COVID-19 experiences long-term sequelae (ie, “long” or “long-haul” COVID). The most common persistent sequelae reported in this group were respiratory symptoms and fatigue. Additionally, according to the study findings, among patients on current systemic anticancer therapy at the time they contracted COVID-19, about 85% were able to continue treatment after COVID-19 resolved.

Alessio Cortellini, MD

Alessio Cortellini, MD

Pasi A. Jänne, MD

Pasi A. Jänne, MD

Commenting on the ever-evolving COVID-19 and cancer story, ESMO Congress 2021 Scientific Co-Chair Pasi A. Jänne, MD, of Dana-Farber Cancer Institute, stated: “This is the second ESMO Congress during the COVID pandemic, and data from this and other studies will provide direction so we can protect our patients during the pandemic.”

Lead author Dr. Cortellini, of the Department of Surgery and Cancer, Imperial College, London, and the Department of Biotechnology and Applied Clinical Sciences, University of L’Aquila, Italy, added: “It is known that 13% to 60% of patients infected with COVID in the general population can experience long-term sequelae, and 60% to 80% of patients with cancer outlive COVID. But there are unanswered questions about the long-term impact of COVID on patients with cancer that this study sought to address.”

More About OnCOVID

The OnCOVID registry includes 2,795 patients with cancer treated at 35 different institutions across six European countries from February 2020 to February 2021. The data presented during ESMO Congress 2021 focused on 1,557 patients reassessed after recovery from COVID-19 to determine the prevalence and impact of COVID-19 sequelae and the effect on post–COVID-19 resumption of systemic anticancer therapy. OnCOVID is expected to be completed during 2022.

At a median post–COVID-19 follow-up of 128 days, long-term sequelae were associated with a 76% increase in the risk of death in an analysis adjusted for sex, age, comorbidities, tumor characteristics, anticancer therapy, and COVID-19 severity.

The study found that 234 patients (15%) had at least one post–COVID-19 complication. The most commonly reported problems included respiratory issues (49.6%), fatigue (41%), neurocognitive issues (7.3%), and weight loss (5.6%).

Factors associated with an increased risk of “long-haul” COVID-19 included age 65 years or older, two or more comorbidities, a history of smoking, increased rates of prior complicated COVID-19, requiring therapy for COVID-19, and requiring hospitalization for COVID-19.

KEY POINTS

  • The study found that 234 (15%) patients had at least one post–COVID-19 sequelae.
  • The most commonly reported problems included respiratory issues (49.6%), fatigue (41%), neuro-cognitive issues (7.3%), and weight loss (5.6%).
  • Factors associated with an increased risk of “long-haul” COVID-19 included age 65 years or older, two or more comorbidities, a history of smoking, increased rates of prior complicated COVID-19, requiring therapy for COVID-19, and requiring hospitalization for COVID-19.

Among 471 patients who were receiving systemic anticancer therapy at the time of diagnosis of COVID-19, COVID-19 sequelae were progressively associated with the continuity of care. At reassessment, 14.8% required permanent discontinuation of cancer treatment, which was associated with a 3.5-fold increase in the risk of death. The most common reason for discontinuation of anticancer therapy was worsening performance status, reported in 61.3% of patients. No adverse impact on survival was found among the 37.8% of patients who required dose adjustments and resumed anticancer therapy. The main factors that led to dose/regimen adjustments were avoiding hospital attendance (25.8%), immunosuppression (50%), and adverse events (19.1%). Anticancer therapy was unchanged in 9.6% of patients post–COVID-19.

“Improved awareness, prevention/recognition, and early treatment of COVID-19 sequelae in patients with cancer are important steps toward optimal management,” Dr. Cortellini stated.

The study authors concluded: “Sequelae post–COVID-19 affect up to 15% of patients with cancer and adversely influence survival and oncological outcomes after recovery. Systemic anticancer therapy adjustments can be safely pursued to preserve oncological outcomes in patients who remain eligible to treatment.”

Disclosure: For full disclosures of the study authors, visit oncologypro.esmo.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
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