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. 2022 Jul:170:10-16.
doi: 10.1016/j.ejca.2022.03.019. Epub 2022 Apr 26.

Persistence of long-term COVID-19 sequelae in patients with cancer: An analysis from the OnCovid registry

Alessio Cortellini  1 , Ramon Salazar  2 , Alessandra Gennari  3 , Juan Aguilar-Company  4 , Mark Bower  5 , Alexia Bertuzzi  6 , Joan Brunet  7 , Matteo Lambertini  8 , Clara Maluquer  9 , Paolo Pedrazzoli  10 , Alvin Jx Lee  11 , MCarmen Carmona-García  7 , Thomas Newsom-Davis  5 , Mieke Van Hemelrijck  12 , Andrea Plaja  13 , Alberto Zambelli  14 , Carlo Tondini  14 , Daniele Generali  15 , Rossella Bertulli  16 , Nikolaos Diamantis  17 , Uma Mukherjee  17 , Gianpiero Rizzo  18 , Tamara Yu  11 , Federica Zoratto  19 , Riccardo Bruna  20 , Anna Sureda  21 , Clara Martinez-Vila  9 , Luca Cantini  22 , Francesca Mazzoni  23 , Federica Grosso  24 , Alessandro Parisi  25 , Maristella Saponara  26 , Aleix Prat  27 , David J Pinato  28 ; On Covid study group
Affiliations

Persistence of long-term COVID-19 sequelae in patients with cancer: An analysis from the OnCovid registry

Alessio Cortellini et al. Eur J Cancer. 2022 Jul.

Abstract

Introduction: A significant proportion of patients with cancer who recover from Coronavirus Disease 2019 (COVID-19) may experience COVID-19 sequelae in the early post-infection phase, which negatively affect their continuity of care and oncological outcome. The long-term prevalence and clinical impact of the post-COVID-19 syndrome in patients with cancer are largely unknown.

Methods: In this study, we describe the time course of COVID-19 sequelae in patients with non-advanced cancers enrolled in the OnCovid registry.

Results: Overall, 186 patients were included, with a median observation period of 9.9 months (95%CI:8,8-11.3) post-COVID-19 resolution. After a median interval of 2.3 months post-COVID-19 (interquartile range: 1.4-3.7), 31 patients (16.6%) reported ≥1 sequelae, including respiratory complications (14, 7.6%), fatigue (13, 7.1%), neuro-cognitive sequelae (7, 3.8%). The vast majority of the patients were not vaccinated prior to COVID-19. COVID-19-related sequelae persisted in 9.8% and 8% of patients 6 and 12 months after COVID-19 resolution. Persistence of sequelae at first oncological follow-up was associated with history of complicated COVID-19 (45.2% vs 24.8%, p = 0.0223), irrespective of oncological features at COVID-19 diagnosis.

Conclusion: This study confirms for the first time that, in a largely unvaccinated population, post-COVID-19 syndrome can affect a significant proportion of patients with non-advanced cancer who recovered from the acute illness. COVID-19 sequelae may persist up to 12 months in some patients, highlighting the need for dedicated prevention and supportive strategies.

Keywords: COVID-19; Long-term; Outcome; SARS-CoV-2; Sequelae.

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Conflict of interest statement

Conflict of interest statement Alessio Cortellini received consulting fees from MSD, BMS, AstraZeneca, Roche; speakers’ fee from AstraZeneca, MSD, Novartis and Eisai. David J Pinato received lecture fees from ViiV Healthcare, Bayer Healthcare, BMS, Roche, EISAI, Falk Foundation, travel expenses from BMS and Bayer Healthcare; consulting fees for Mina Therapeutics, EISAI, Roche, DaVolterra and Astra Zeneca; research funding (to institution) from MSD and BMS. Aleix Prat has declared personal honoraria from Pfizer, Roche, MSD Oncology, Eli Lilly, and Daiichi Sankyo; travel, accommodations and expenses paid by Daiichi Sankyo; research funding from Roche and Novartis; and consulting/advisory role for NanoString Technologies, Amgen, Roche, Novartis, Pfizer and Bristol-Myers Squibb. Matteo Lambertini acted as consultant for Roche, Novartis, Lilly, AstraZeneca, Exact Sciences, MSD, Pfizer, Seagen and received speaker honoraria from Roche, Novartis, Lilly, Pfizer, Takeda, Ipsen and Sandoz outside the submitted work. Thomas Newsom-Davis has declared consulting/advisory role for Amgen, Bayer, AstraZeneca, BMS, Boehringer Ingelheim, Eli Lilly, MSD, Novartis, Otsuka, Pfizer, Roche, and Takeda; speakers fees from AstraZeneca, MSD, Roche, Takeda and travel, accommodations and expenses paid by AstraZenca, BMS, Boehringer Ingelheim, Lilly, MSD, Otsuka, Roche, and Takeda. Joan Brunet has declared consulting/advisory role for MSD and Astra Zeneca. Alessandra Gennari has declared consulting/advisory role for Roche, MSD, Eli Lilly, Pierre Fabre, EISAI, and Daichii Sankyo; speakers bureau for Eisai, Novartis, Eli Lilly, Roche, Teva, Gentili, Pfizer, Astra Zeneca, Celgene, and Daichii Sankyo; research funds: EISAI, Eli Lilly, and Roche. CMV has received travel grants and other honoraria from BMS, MSD, Novartis and Roche. Gianluca Gaidano has declared consulting/advisory role for Janssen, Abbvie, Astra-Zeneca and BeiGene, and speaker fees from Janssen and Abbvie. Lorenza Rimassa received consulting fees from Servier, Amgen, ArQule, AstraZeneca, Basilea, Bayer, BMS, Celgene, Eisai, Exelixis, Genenta, Hengrui, Incyte, Ipsen, IQVIA, Lilly, MSD, Nerviano Medical Sciences, Roche, Sanofi, Zymeworks; lecture fees from AbbVie, Amgen, Bayer, Eisai, Gilead, Incyte, Ipsen, Lilly, Merck Serono, Roche, Sanofi; travel expenses from Ipsen; and institutional research funding from Agios, ARMO BioSciences, AstraZeneca, BeiGene, Eisai, Exelixis, Fibrogen, Incyte, Ipsen, Lilly, MSD, Nerviano Medical Sciences, Roche, Zymeworks. All remaining authors have declared no conflicts of interest.

Figures

Fig. 1
Fig. 1
Study flow diagram.
Fig. 2
Fig. 2
Prevalence of COVID-19 sequelae. A) Prevalence at the first clinical reassessment (31/184: 16%), at 6 months (18/184: 9.8%) and at 12 months (8/100: 8%). Type of sequelae at the first reassessment: respiratory sequelae (14: 7.6%), fatigue (13: 7.1%), neuro-cognitive sequelae (7: 3.8%), others (7: 3.8%). Type of sequelae at the 6-months reassessment: respiratory sequelae (9: 4.9%), fatigue (6: 3.2%), neuro-cognitive sequelae (4: 2.2%), others (5: 2.7%). Type of sequelae at the 12-months reassessment: respiratory sequelae (3: 3%), fatigue (3: 3%), neuro-cognitive sequelae (1: 1%), others (3: 3%). B) Prevalence of COVID-19 sequelae at the first reassessment among never smokers (8/83: 9.6%), current/former smokers (17/64: 26.6%), among patients who did not experience prior complications from COVID-19 (17/132: 12.9%) and those who experienced complicated COVID-19 (14/52: 26.9%).
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