Long COVID in cancer patients: preponderance of symptoms in majority of patients over long time period

  1. Hiba Dagher
  2. Anne-Marie Chaftari  Is a corresponding author
  3. Ishwaria M Subbiah
  4. Alexandre E Malek
  5. Ying Jiang
  6. Peter Lamie
  7. Bruno Granwehr
  8. Teny John
  9. Eduardo Yepez
  10. Jovan Borjan
  11. Cielito Reyes-Gibby
  12. Mary Flores
  13. Fareed Khawaja
  14. Mala Pande
  15. Noman Ali
  16. Raniv Rojo
  17. Daniel D Karp
  18. Patrick Chaftari
  19. Ray Hachem
  20. Issam I Raad
  1. Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, United States
  2. Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, United States
  3. Hospital Medicine, The University of Texas MD Anderson Cancer Center, United States
  4. Pharmacy Clinical Programs, The University of Texas MD Anderson Cancer Center, United States
  5. Emergency Medicine-Research, The University of Texas MD Anderson Cancer Center, United States
  6. Gastroenterology Research, The University of Texas MD Anderson Cancer Center, United States
  7. Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, United States
  8. Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, United States
  9. Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, United States
1 figure, 1 table and 1 additional file

Figures

Post-acute sequela of SARS-CoV-2 infection (PASC)-related symptoms.

Tables

Table 1
Comparing COVID-19 cancer patients with and without long-term symptoms (at least 30 days after their COVID-19 diagnosis).
VariablesHaving long-term symptomsp-Value
NoYes
(n=124)(n=188)
N (%)N (%)
Age (years), median (range)57 (18–85)57 (21–86)0.47
Age ≥6533 (27)50 (27)>0.99
Gender0.036
Male61 (49)70 (37)
Female63 (51)118 (63)
Race0.45
Caucasian66 (53)102 (54)
Black24 (19)26 (14)
Hispanic28 (23)52 (28)
Asian5 (4)8 (4)
Other1 (1)0 (0)
Prior COPD/bronchiolitis obliterans4 (3)7 (4)>0.99
History of hypertension70 (56)69/187 (37)<0.001
History of heart failure3 (2)5/186 (3)>0.99
Type of cancer0.92
Hematological malignancy31 (25)48 (26)
Solid tumor93 (75)140 (74)
Metastasis42/93 (45)74/140 (53)0.25
Status of cancer0.023
Being treated initially65/123 (53)96 (51)
Remission22/123 (18)56 (30)
Refractory or relapse36/123 (29)36 (19)
Chemotherapy within 1 year prior to COVID-1974 (60)94 (50)0.09
Immunotherapy within 6 months prior to COVID-197/123 (6)9/186 (5)0.74
Radiation therapy within 6 months prior to COVID-1912 (10)20 (11)0.78
Severe COVID-19 at diagnosis32 (26)25 (14)0.009
Cancer treatment delayed46/108 (43)66/174 (38)0.44
Mortality*33 (27)18 (10)<0.0001
Hypoxia at diagnosis25 (20)23/180 (13)0.08
Oxygen flow at diagnosis0.20
High flow6/30 (20)6/43 (14)
Low flow15/30 (50)15/43 (35)
None9/30 (30)22/43 (51)
Non-invasive ventilation at diagnosis16 (13)13/179 (7)0.10
Lab values at COVID-19 diagnosis
ALC <1 K/µL44/74 (59)57/94 (61)0.88
ANC <0.5 K/µL5/75 (7)5/89 (6)>0.99
Hemoglobin <10 g/dL23/65 (35)16/78 (21)0.06
LDH ≥250 U/L29/58 (50)41/67 (61)0.21
D-dimer ≥1 mcg/mL28/54 (52)27/61 (44)0.42
Ferritin ≥500 ng/mL30/54 (56)36/59 (61)0.56
CRP ≥40 mg/L32/56 (57)43/63 (68)0.21
IL-6 ≥25 pg/mL18/41 (44)20/48 (42)0.83
LRTI at diagnosis or progression to LRTI29 (23)35/182 (19)0.38
Hospital admission52 (42)65 (35)0.19
Remdesivir treatment17 (14)18 (10)0.26
IL-6 pathway inhibitors – tocilizumab8 (6)5 (3)0.10
Convalescent plasma8 (6)15 (8)0.61
Steroids18 (15)19 (10)0.24
Multiorgan failure6/121 (5)8/180 (4)0.84
  1. *

    1. Patients who died within 30 days after COVID-19 diagnosis were excluded from this study. 2. Mortality status was determined within 14 months after COVID-19 diagnosis.

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  1. Hiba Dagher
  2. Anne-Marie Chaftari
  3. Ishwaria M Subbiah
  4. Alexandre E Malek
  5. Ying Jiang
  6. Peter Lamie
  7. Bruno Granwehr
  8. Teny John
  9. Eduardo Yepez
  10. Jovan Borjan
  11. Cielito Reyes-Gibby
  12. Mary Flores
  13. Fareed Khawaja
  14. Mala Pande
  15. Noman Ali
  16. Raniv Rojo
  17. Daniel D Karp
  18. Patrick Chaftari
  19. Ray Hachem
  20. Issam I Raad
(2023)
Long COVID in cancer patients: preponderance of symptoms in majority of patients over long time period
eLife 12:e81182.
https://doi.org/10.7554/eLife.81182