According to data from a European registry, approximately 1 in 6 patients with cancer who recovered from COVID-19 infection experienced long-term sequelae (ie, “long-haul” COVID-19), placing them at increased risk for death or discontinuation of anticancer treatment. These results were presented by Alessio Cortellini, MD, Consulting Medical Oncologist and Visiting Researcher, Department of Surgery and Cancer, Imperial College, London, England, and Researcher, Department of Biotechnology and Applied Clinical Sciences, University of L’Aquila, Italy, at the virtual European Society for Medical Oncology Congress 2021.
“It is known that 13% to 60% of COVID-19 patients 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,” Dr Cortellini stated.
The OnCOVID registry gathered data on a total of 2795 patients with cancer who were treated at 35 different institutions across 6 European countries from February 2020 to February 2021. Dr Cortellini presented results from 1557 patients with cancer who underwent reassessment after they recovered from COVID-19 to characterize the prevalence and impact of COVID-19 sequelae, and whether systemic anticancer therapy could be resumed.
At a median post–COVID-19 follow-up of 128 days, long-term sequelae were associated with a 76% increase in the risk for death in an analysis adjusted for sex, age, comorbidities, tumor characteristics, anticancer therapy, and COVID-19 severity.
Among the 1557 patients with cancer who had recovered from COVID-19, 234 (15%) suffered at least 1 post–COVID-19 sequelae. The most frequently reported sequelae included respiratory symptoms (49.6%), fatigue (41%), neurocognitive issues (7.3%), and weight loss (5.6%).
Factors associated with an increased risk for long-haul COVID-19 included being male, age ≥65 years, the presence of ≥2 comorbidities, current or former smoking history, and increased rates of previous complicated COVID-19, requiring therapy for COVID-19, and requiring hospitalization for COVID-19.
Of the 471 patients who were being treated with systemic anticancer therapy at the time of COVID-19 diagnosis, long-haul COVID-19 was more prevalent among those who discontinued anticancer care. When patients were reassessed after COVID-19, 14.8% required permanent discontinuation of cancer treatment, which was associated with a 3.5-fold increase in the risk for death. The most common reason for discontinuation of anticancer therapy was worsening performance status, which was reported in 61.3% of patients.
Among patients who required dose adjustments and resumed anticancer therapy (37.8%), survival was not compromised. The main factors that led to dose or regimen adjustments were avoiding hospital attendance (25.8%), immunosuppression (50%), or adverse events (19.1%). Anticancer therapy was unchanged in 9.6% of patients post–COVID-19.
“OnCOVID data suggest that improved awareness, prevention, recognition, and early treatment of COVID-19 sequelae in patients with cancer are important steps toward optimal management,” Dr Cortellini concluded.