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SARS-CoV-2 infection can cause sequelae in up to 15% of cancer patients who survive COVID-19.[1]
A new European investigation with Spanish participation, published in The Lancet Oncology, evaluated the impact of vaccination against COVID-19 in cancer patients during the last wave of the omicron variant, compared to other phases of the pandemic. The results confirm the role of prior immunization as an effective measure to protect patients from the sequelae of COVID-19, treatment interruption, and consequent mortality.[2]
The researchers used data from OnCovidactive registry that includes patients aged 18 years or older from 37 institutions in Belgium, France, Germany, Italy, Spain, and the United Kingdom with a laboratory-confirmed diagnosis of COVID-19 and a history of solid or hematologic malignancy, active or in remission, with follow-up from the diagnosis of COVID-19 until death.
The researchers evaluated the presence of sequelae of COVID-19 in patients who had survived the disease. The infection was classified according to the date of diagnosis as: omicron phase (from December 15, 2021 to January 31, 2022), alpha-delta (from December 1, 2020 to December 14, 2021) and a pre-infection phase. vaccination from February 27 to November 30, 2020. The prevalence of general sequelae (defined as the presence of symptoms between 4 and 12 weeks after infection) of COVID-19 was compared according to the immunization status against SARS- CoV-2, post-COVID-19 survival, and resumption of systemic cancer therapy.
Finally, data from 1,909 eligible patients were analyzed, evaluated after a median of 39 days (interquartile range [IQR]: 24 to 68) since the diagnosis of COVID-19 (50.7% women and 49.3% men).
Aftermath of COVID-19
In total, 317 (16.6%; 95% confidence interval [IC 95%]: 14.8 to 18.5) of 1,909 patients had at least one sequel at the first oncological reassessment: with respiratory sequelae (9%), prolonged fatigue (7%), weight loss (1.6%), neurocognitive sequelae (2.9%) and other organic dysfunctions (1.3%).
The prevalence of sequelae was higher in the pre-vaccination phase (191 [19,1%; IC 95%: 16,4 a 22,0] than 1,000 patients), being similar in the alpha-delta phase (110 [16,8%; 13,8 a 20,3] of 653 patients; p = 0.24), but significantly lower in the omicron phase (16 [6,2%; 3,5 a 10,2] of 256 patients; p < 0,0001).
Previous vaccination and development of sequelae
In the alpha-delta phase, 84 (18.3%; 95% CI: 14.6 to 22.7) of 458 unvaccinated patients and 3 (9.4%; 1.9 to 27.3) of 32 unvaccinated patients vaccinated in the omicron phase had sequelae. Patients who received a booster dose and those who received two doses of vaccine had a significantly lower prevalence of sequelae than unvaccinated or partially vaccinated patients:
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Overall: 10 (7.4%; 95% CI 3.5 to 13.5) of 136 booster patients, 18 (9.8%; 95% CI 5.8 to 15.5) of 183 patients who received two doses of vaccine versus 277 (18.5%; 95% CI: 16.5 to 20.9) of 1,489 unvaccinated patients (p = 0,0001).
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Respiratory sequelae: 6 (4.4%; 95% CI 1.6 to 9.6) of 136 with booster dose, 11 (6.0%; 95% CI 3.0 to 10.7) of 183 with two doses versus 148 (9.9%; 95% CI: 8.4 to 11.6) of 1,489 unvaccinated; p = 0,030).
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Prolonged fatigue: 3 (2.2%, 95% CI 0.1 to 6.4) of 236 with booster dose, 10 (5.4%, 95% CI 2.6 to 10.0) of 183 with two doses versus 115 (7.7%; 95% CI: 6.3 to 9.3) of 1,489 unvaccinated (p = 0,037).
conclusions
The study authors conclude by noting that “unvaccinated cancer patients remain highly vulnerable to the sequelae of COVID-19, regardless of variant. This study confirms the role of prior immunization against SARS-CoV-2 as a measure effective in protecting patients from the sequelae of COVID-19, discontinuation of treatment, and consequent mortality.”
This content was originally published on Univadispart of the Medscape Professional Network.
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