300. Long COVID in Cancer Patients: Preponderance of Symptoms in Majority of Patients Over Long Time Period

Abstract

Background An increasing number of observational studies have reported the persistence of symptoms following recovery from acute COVID-19 disease. The long-term consequences of COVID-19 are not fully understood and there is no clear consensus on the definition of post-acute sequelae of SARS-CoV-2 infection (PASC). The reported prevalence of PASC widely varies from 10% up to 87%. The purpose of this study is to assess PASC in cancer patients following acute COVID-19 recovery. Methods We assessed cancer patients at MD Anderson Cancer Center who were diagnosed with COVID-19 disease between March 1, 2020 and Sept 1, 2020. Using patient questionnaires and medical chart reviews we followed these patients from March 2020 till May 2021. Patient questionnaires were sent out remotely daily for 14 days after COVID-19 diagnosis then weekly for 3 months, and then monthly thereafter. Chart reviews were conducted for each patient hospital re-admission and emergency department visit. These admissions were classified as either COVID-19 related or non-related. The persistence or emergence of new COVID19-related symptoms were captured at each COVID-19 related admission. Results We included 312 cancer patients with a median age of 57 years (18-86). The majority of patients had solid tumors (75%). Of the 312 patients, 188 (60%) reported long COVID-19 symptoms with a median duration of 7 months and up to 14 months after COVID-19 diagnosis. The most common symptoms reported included fatigue (82%), sleep disturbances (78%), myalgias (67%) and gastrointestinal symptoms (61%), followed by headache, altered smell or taste, dyspnea (47%) and cough (46%). A higher number of females reported a persistence of symptoms compared to males (63% vs 37%; p=0.036). Cancer type, neutropenia, lymphocytopenia, and hospital admission during acute COVID-19 disease were comparable in both groups and did not seem to contribute to a higher number of long-COVID-19 patients in our study group. Conclusion Long-COVID occurs in 60% of cancer patients and may persist up to 14 months after acute illness. The most common symptoms are fatigue, sleep disturbance, myalgia and gastro-intestinal symptoms. Disclosures Fareed Khawaja, MBBS, Eurofins Viracor (Research Grant or Support)

Cancer, more than a “COVID-19 co-morbidity”

“…Long-COVID is associated with not only increased hospitalization for COVID-19 and complicated COVID-19 but also with an increased risk of death ( 65 ). It is observed that Long-Covid occurs in 60% of cancer patients, and it may persist up to 14 months after acute illness ( 123 ). Future investigation will guide us in deciding expectant management and surveillance imaging in these Long-COVID with cancer patients ( Figure 12 ).…”

Long COVID: Clinical Framing, Biomarkers, and Therapeutic Approaches

“…Post-COVID-19 effects included fatigue, sleep disturbances, myalgia, gastrointestinal symptoms, dyspnea, and cough in 82%, 78%, 67%, 61%, 47%, and 46%, respectively. Of note, the persistence of these symptoms was higher in women than in men (63% vs. 37%, p = 0.036) [ 92 ]. No association was found between cancer types and long COVID-19 sequelae.…”

“…Characteristics of patients were a median age of 64 years (range: 54–72 years), (ii) female sex (60.4%), (iii) non-Hispanic white ethnicity (76.8%), and (iv) current or former smokers (41.1%). In addition, cancer patients with long COVID had more comorbidities (OR = 4.3, [95%CI 2.9–6.2], p < 0.0001), and were more likely to be hospitalized for COVID-19 (OR = 1.3, [95%CI 1.0–1.7], p = 0.05) compared with non-cancer subjects [ 92 ]. This evidence supports the hypothesis that cancer patients are more susceptible to both COVID-19 acute and long-term complications as compared with non-cancer patients.…”