About 15% of cancer patients who developed COVID-19 had long-term effects from the infection that adversely impacted their cancer outcomes, a European study found.
At a median follow-up of 128 days, respiratory symptoms, chronic fatigue, weight loss, and neuro-cognitive issues persisted in these patients, said Alessio Cortellini, MD, of Imperial College London in England and the University of L'Aquila in Italy, during a press briefing in advance of the annual congress of the European Society for Medical Oncology, which begins next week.
In addition, he said, results of a multivariable analysis adjusted for sex, age, comorbidities, tumor characteristics, anti-cancer therapy, and COVID-19 severity showed that the long-term sequelae were associated with an increased risk of death (HR 1.76, 95% CI 1.16-2.66).
Data for the study came from OnCOVID, which includes information on patients with a history of cancer and COVID-19, collected from 35 institutions in six European countries.
Cortellini noted that while cancer patients are especially vulnerable to COVID-19, the vast majority survive the infection. The impact of post-COVID syndromes on prognosis and continuity of cancer care, however, remain unclear, he added.
The study ran from February 2020 to February 2021 and included a total of 2,795 patients, 1,557 of whom underwent clinical reassessment after recovering from COVID-19.
A total of 15% of patients reported at least one sequelae, including respiratory symptoms (49.6% of patients), fatigue (41%), neuro-cognitive dysfunction (7.3%), and weight loss (5.5%). These patients were more likely to be male, older than 65, to have at least two comorbidities or a history of smoking, and to have COVID that required therapy or hospitalization.
"Basically, the message here is that although these were all COVID survivors, the worse the disease, the higher the chance of experiencing the sequelae," Cortellini said, adding that the findings are important considering the likely beneficial impact vaccination could have in these patients.
Regarding the impact of COVID-19 on continuity of cancer care, Cortellini and colleagues found that among patients who were undergoing systemic anti-cancer therapy at the time of COVID-19 diagnosis, 14.8% permanently discontinued treatment, while 37.8% resumed treatment after a dose or regimen adjustment.
"This isn't bad considering that those regimen adjustments were not associated with worse COVID survival in this update," Cortellini said. In addition, COVID-19 sequelae "were significantly and progressively associated with [treatment] resumption pathways."
Specifically, only 9.6% of patients who resumed treatments without any changes to therapy had at least one sequelae, compared with 14.6% of those who had their dose/regimen adjusted and 22.9% of patients who permanently discontinued treatment.
"That means that if we manage to prevent COVID sequelae -- meaning the better we treat COVID -- we can prevent this disruption of continuity of care," said Cortellini.
Cortellini reported relationships with Bristol Myers Squibb, Roche, MSD, Novartis, AstraZeneca, and Eisai.
European Society for Medical Oncology
Source Reference: Cortellini A, et al "Prevalence and impact of COVID-19 sequelae on treatment pathways and survival of cancer patients who recovered from SARS-COV-2 infection" ESMO 2021; Abstract 1560.