Long-term COVID-19 effects impact 15% of patients with cancer, may impair outcomes
At least 15% of patients with cancer who recovered from COVID-19 experienced post-infection sequelae that can impair outcomes and oncologic continuity of care, according to data presented at the opening press conference of ESMO Congress.
“There is a post-COVID syndrome in the general population that accounted for between 50% to 60% of patients, depending on the report,” Alessio Cortellini, MD, of the department of surgery and cancer at Imperial College London and department of biotechnology and applied clinical sciences at University of L’Aquila in Italy, said during the briefing. “Although we are confident in saying that patients with cancer are especially vulnerable in relation to COVID-19, we can now say from a positive perspective that up to 80% of them outlive COVID-19, thanks to guidelines, leaving unanswered the question about the impact of post-COVID-19 syndromes on them and, in particular, on their post-COVID oncological continuity of care.”
Cortellini and colleagues investigated the frequency and impact of COVID-19 sequelae on patients with cancer and COVID-19 in the European OnCOVID registry, which included 2,795 patients from 35 institutions in six countries diagnosed with COVID-19 between Feb. 27, 2020, and Feb. 14, 2021.
The study included 1,557 COVID-19 survivors reassessed after recovery at participating institutions. Among them, 235 (15%) reported at least one sequelae from COVID-19, such as respiratory symptoms (49.6%), fatigue (41%), neurocognitive dysfunction (7.3%) and weight loss (5.5%). Those more likely to experience persistent COVID-19 sequelae included men vs. women (54.5% vs. 47.2%), those aged 65 years or older vs. younger than 65 years (55.1% vs. 48.1%), those with two or more vs. fewer comorbidities (48.3% vs. 36.4%) and those with vs. without a smoking history (55.9% vs. 42.3%). Researchers also reported associations of sequelae with a history of prior COVID-19 hospitalization (72.2% vs. 41.2%), prior complicated COVID-19 (54.3% vs. 20.9%) and receipt of COVID-19 therapy (65.8% vs. 52.6%).
“The worse the disease, the higher the chances of experiencing COVID-19 sequelae,” Cortellini said. “These are important findings because we can think about the impact of COVID vaccination and the likely beneficial effect that immunization can [have] on these aspects specifically.”
Results of multivariable analysis adjusted for age, sex, comorbidities, tumor characteristics, anticancer therapy and COVID-19 severity showed associations of COVID-19 sequelae with a 76% increased risk for death (HR = 1.76; 95% CI 1.16–2.66).
Among patients who had been receiving systemic anticancer therapy when diagnosed with COVID-19, 14.8% discontinued therapy permanently and 37.8% resumed therapy after dose or regimen adjustments.
“This is not bad if we consider that those regimen adjustments were not associated with worse post-COVID survival in this update,” Cortellini said.
Reasons for therapy cessation included declining performance status (61.3%), disease progression (29%) and residual organ dysfunction (9.7%). Reasons for dose/regimen adjustments included to avoid immune suppression (50%), hospital attendance (25.8%), IV administration (19.1%) or other adverse events (7.9%).
“If we manage to prevent COVID-19 sequelae — meaning the better we treat COVID — we can prevent this disruption of continuity of care,” Cortellini said.
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Cortellini A, et al. Abstract 1560O_PR. Presented at: European Society for Medical Oncology Congress opening press conference (virtual); Sept. 9, 2021.
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