Short Report

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

Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas MD Anderson Cancer Center, United States
Integrative Medicine Program, The University of Texas MD Anderson Cancer Center, United States
Hospital Medicine, The University of Texas MD Anderson Cancer Center, United States
Pharmacy Clinical Programs, The University of Texas MD Anderson Cancer Center, United States
Emergency Medicine-Research, The University of Texas MD Anderson Cancer Center, United States
Gastroenterology Research, The University of Texas MD Anderson Cancer Center, United States
Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, United States
Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, United States
Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, United States

Feb 7, 2023

https://doi.org/10.7554/eLife.81182

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Accepted for publication after peer review and revision.

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Version of Record published: March 1, 2023 (This version)
Accepted Manuscript published: February 7, 2023 (Go to version)
Accepted: January 23, 2023
Preprint posted: July 15, 2022 (Go to version)
Received: June 17, 2022

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1 figure, 1 table and 1 additional file

Figures

Figure 1

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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).

Variables	Having long-term symptoms		p-Value
	No	Yes
	(n=124)	(n=188)
	N (%)	N (%)
Age (years), median (range)	57 (18–85)	57 (21–86)	0.47
Age ≥65	33 (27)	50 (27)	>0.99
Gender			0.036
Male	61 (49)	70 (37)
Female	63 (51)	118 (63)
Race			0.45
Caucasian	66 (53)	102 (54)
Black	24 (19)	26 (14)
Hispanic	28 (23)	52 (28)
Asian	5 (4)	8 (4)
Other	1 (1)	0 (0)
Prior COPD/bronchiolitis obliterans	4 (3)	7 (4)	>0.99
History of hypertension	70 (56)	69/187 (37)	<0.001
History of heart failure	3 (2)	5/186 (3)	>0.99
Type of cancer			0.92
Hematological malignancy	31 (25)	48 (26)
Solid tumor	93 (75)	140 (74)
Metastasis	42/93 (45)	74/140 (53)	0.25
Status of cancer			0.023
Being treated initially	65/123 (53)	96 (51)
Remission	22/123 (18)	56 (30)
Refractory or relapse	36/123 (29)	36 (19)
Chemotherapy within 1 year prior to COVID-19	74 (60)	94 (50)	0.09
Immunotherapy within 6 months prior to COVID-19	7/123 (6)	9/186 (5)	0.74
Radiation therapy within 6 months prior to COVID-19	12 (10)	20 (11)	0.78
Severe COVID-19 at diagnosis	32 (26)	25 (14)	0.009
Cancer treatment delayed	46/108 (43)	66/174 (38)	0.44
Mortality*	33 (27)	18 (10)	<0.0001
Hypoxia at diagnosis	25 (20)	23/180 (13)	0.08
Oxygen flow at diagnosis			0.20
High flow	6/30 (20)	6/43 (14)
Low flow	15/30 (50)	15/43 (35)
None	9/30 (30)	22/43 (51)
Non-invasive ventilation at diagnosis	16 (13)	13/179 (7)	0.10
Lab values at COVID-19 diagnosis
ALC <1 K/µL	44/74 (59)	57/94 (61)	0.88
ANC <0.5 K/µL	5/75 (7)	5/89 (6)	>0.99
Hemoglobin <10 g/dL	23/65 (35)	16/78 (21)	0.06
LDH ≥250 U/L	29/58 (50)	41/67 (61)	0.21
D-dimer ≥1 mcg/mL	28/54 (52)	27/61 (44)	0.42
Ferritin ≥500 ng/mL	30/54 (56)	36/59 (61)	0.56
CRP ≥40 mg/L	32/56 (57)	43/63 (68)	0.21
IL-6 ≥25 pg/mL	18/41 (44)	20/48 (42)	0.83
LRTI at diagnosis or progression to LRTI	29 (23)	35/182 (19)	0.38
Hospital admission	52 (42)	65 (35)	0.19
Remdesivir treatment	17 (14)	18 (10)	0.26
IL-6 pathway inhibitors – tocilizumab	8 (6)	5 (3)	0.10
Convalescent plasma	8 (6)	15 (8)	0.61
Steroids	18 (15)	19 (10)	0.24
Multiorgan failure	6/121 (5)	8/180 (4)	0.84

*

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.