medwireNews: Around one in seven people with cancer and COVID-19 report persistent symptomatic sequelae of the infection after recovery, suggest data from the OnCovid study.
The sequelae were associated with features of COVID-19 severity, and may impair post-COVID-19 survival and continuity of oncologic care, said presenting author Alessio Cortellini (Imperial College London, UK) at the ESMO Congress 2021.
The team identified 1557 OnCovid participants with a history of a solid or hematologic malignancy who received a confirmed diagnosis of SARS-CoV-2 between February 2020 and February 2021 and underwent clinical assessment after recovering from the infection. Participants were followed up for a median 128 days after COVID-19.
Just over half (51.7%) of the study population were women, 50.8% were aged younger than 65 years, and the majority (61.8%) had no or one comorbidity. The most common tumor type in the cohort was breast cancer (23.4%), followed by genitourinary and gynecologic cancers (19.3%).
In all, 15.0% of participants reported at least one long-term effect of COVID-19, most commonly respiratory symptoms, at 49.6%, and chronic fatigue, at 41.0%.
The likelihood of experiencing persistent symptoms was significantly greater for men versus women (54.4 vs 47.2%), those aged at least 65 years versus younger participants (55.1 vs 48.1%), those with at least two versus fewer comorbidities (48.3 vs 36.4%), and participants with versus without a smoking history (55.9 vs 42.3%).
Long-term sequelae were also significantly more likely among those who did versus did not have a complicated COVID-19 course (54.3 vs 20.9%) as well as those who did versus did not require COVID-19 therapy (65.8 vs 52.6%) or hospitalization (72.2 vs 41.2%).
The presence of at least one persistent symptom was associated with worse survival after COVID-19, while “multiple sequelae within the same patient had a progressive, negative prognostic impact,” said the presenter.
And multivariable analysis of data from 870 patients showed a significant association between COVID-19 sequelae and an increased risk for death, at a hazard ratio (HR) of 1.76, after adjusting for factors such as sex, age, tumor features, and receipt of COVID-19 and anticancer therapies.
Of the 471 participants who had been receiving systemic anticancer treatment within 4 weeks of the COVID-19 diagnosis, 14.8% permanently discontinued treatment after COVID-19, primarily due to a deterioration of performance status or disease progression, while 37.8% resumed treatment with an adjusted dose or regimen, mainly to avoid immune suppression.
“Reassuringly, dose and regimen adjustments were not associated with a shortened post-COVID survival, even though these are preliminary data, while unsurprisingly permanent discontinuation was,” with an HR for death of 3.53 in multivariable analysis, reported Cortellini.
He acknowledged some limitations of the data, such as the “absence of periodic and pre-planned diagnostic tests for sequelae assessment,” but believes that the study provides “informative evidence” about the long-term effects of COVID-19 in this patient population.
And he concluded: “Improved awareness, recognition and early treatment of COVID-19 sequelae in patients with cancer is an important step towards the promotion of optimal oncological outcomes in COVID-19 survivors.”
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2021 Springer Healthcare Ltd, part of the Springer Nature Group
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