More Than 1 in 2 Cancer Patients at Risk of Long COVID

Highlights:

Cancer patients are at a high risk of COVID-19
More than 50% of cancer patients were found to have suffered from long COVID
Female cancer patients had a higher rate of long COVID (63% versus 51%) than male cancer patients

More than one in every two cancer patients at a US cancer center showed signs of long COVID for more than six months after the first infection, revealed a study published in eLife.

The findings are equivalent to the reported incidence of long COVID in the general population, but women undergoing cancer therapy appear to be at higher risk than men.

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‘A follow-up study of cancer patients after COVID-19 found that one in every two had a long COVID, but only a few required hospitalizations and the majority could be treated as outpatients.’

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Prevalence of Long COVID

Reports of the prevalence of long COVID - also known as post-acute sequelae of SARS-CoV-2 infection (PASC) - in the general population range from 10% to 87%, with symptoms lasting longer than 30 days in individuals who had severe initial COVID-19 symptoms or were hospitalized.

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Post-COVID-19 Management Among Cancer Patients

“Although cancer patients fall into a higher COVID-19 risk group there is limited data on PASC in cancer patients and how it affects their progression, care and treatment,” says lead author Anne-Marie Chaftari, Associate Professor, Department of Infectious Diseases, the University of Texas MD Anderson Cancer Center, Texas, US. “To provide a better understanding of post-COVID-19 management among cancer patients, we sought to characterize the patterns of long COVID specifically in these patients.”

The researchers selected patients at the University of Texas MD Anderson Cancer Center who were diagnosed with COVID-19 between March and September 2020 and followed their progress for up to 14 months using remote symptom monitoring and routine hospital visits. Patients were sent questionnaires daily for 14 days following their first COVID-19 diagnosis, then weekly for three months, and monthly thereafter. Patients were asked to keep track of symptoms such as fatigue, cough, chest tightness, difficulty breathing, headache, fever, altered sense of smell or taste, muscle aches, gastrointestinal (GI) problems, sleep disturbance, and any limits with daily activities. Long COVID symptoms were defined as COVID-19-related symptoms that lasted more than 30 days after diagnosis or the appearance of new COVID-19 symptoms.

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Long COVID in Cancer Patients

They obtained data from 312 cancer patients, 188 (60%) of whom had long COVID. Those who had relapsed or had treatment-resistant malignancy at the start of the study, as well as those who had more severe acute COVID-19 infections, were less likely to have long COVID infections. Female cancer patients had a greater rate of long COVID-19 than male cancer patients (63% versus 51%). There was no difference in the characteristics of patients who developed long COVID and those who did not; risk factors such as low white blood cell count, need for oxygen, hospitalization for COVID-19 or multi-organ failure were identical in both groups. Fatigue, sleep problems, muscle discomfort, and GI issues were the most prevalent long COVID symptoms.

One surprising finding was that people with high blood pressure (BP) were less likely to have a long COVID. This was unexpected considering that elevated blood pressure is a known risk factor for more severe acute COVID-19, but a similar finding was reported in another investigation of long COVID in immuno-compromised individuals. The link between blood pressure and the risk of severe acute COVID-19 is considered to be related to the binding of the COVID-19 spike protein to angiotensin-converting enzyme 2 (ACE-2), which is the target of many blood pressure-lowering medicines. These findings may rule out the role of this mechanism in the development of long COVID.

59 (31%) of the 188 cancer patients who acquired lengthy COVID-19 were readmitted to the hospital, however, only 16 (8.5%) were readmitted for COVID-19-related reasons, with the majority having symptoms that could be handled with outpatient therapy.

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Gender Disparity in Cancer Patients with Long COVID

“Our study found that long COVID occurred in the majority of our cancer patients and was more prevalent in women than men,” concludes senior author Issam Raad, endowed distinguished chair and professor in the Department of Infectious Diseases, the University of Texas MD Anderson Cancer Center. “Even in this high-risk patient population, long COVID was not associated with a high rate of hospital admissions. We also found no underlying condition or severity of illness during acute COVID-19 that would predict long COVID.”

Source-Medindia