Background COVID-19 sequelae can affect about 15% of patients with cancer who survive the acute phase of SARS-CoV-2 infection and can substantially impair their survival and continuity of oncological care. We aimed to investigate whether previous immunisation affects long-term sequelae in the context of evolving variants of concern of SARS-CoV-2. Methods OnCovid is an active registry that includes patients aged 18 years or older from 37 institutions across Belgium, France, Germany, Italy, Spain, and the UK with a laboratory-confirmed diagnosis of COVID-19 and a history of solid or haematological malignancy, either active or in remission, followed up from COVID-19 diagnosis until death. We evaluated the prevalence of COVID-19 sequelae in patients who survived COVID-19 and underwent a formal clinical reassessment, categorising infection according to the date of diagnosis as the omicron (B.1.1.529) phase from Dec 15, 2021, to Jan 31, 2022; the alpha (B.1.1.7)-delta (B.1.617.2) phase from Dec 1, 2020, to Dec 14, 2021; and the pre-vaccination phase from Feb 27 to Nov 30, 2020. The prevalence of overall COVID-19 sequelae was compared according to SARS-CoV-2 immunisation status and in relation to post-COVID-19 survival and resumption of systemic anticancer therapy. This study is registered with ClinicalTrials.gov, NCT04393974. Findings At the follow-up update on June 20, 2022, 1909 eligible patients, evaluated after a median of 39 days (IQR 24-68) from COVID-19 diagnosis, were included (964 [ 50 center dot 7%] of 1902 patients with sex data were female and 938 [49 center dot 3%] were male). Overall, 317 (16 center dot 6%; 95% CI 14 center dot 8-18 center dot 5) of 1909 patients had at least one sequela from COVID-19 at the first oncological reassessment. The prevalence of COVID-19 sequelae was highest in the prevaccination phase (191 [19 center dot 1%; 95% CI 16 center dot 4-22 center dot 0] of 1000 patients). The prevalence was similar in the alpha-delta phase (110 [16 center dot 8%; 13 center dot 8- 20 center dot 3] of 653 patients, p=0 center dot 24), but significantly lower in the omicron phase (16 [6 center dot 2%; 3 center dot 5-10 center dot 2] of 256 patients, p<0 center dot 0001). In the alpha- delta phase, 84 (18 center dot 3%; 95% CI 14 center dot 6-22 center dot 7) of 458 unvaccinated patients and three (9 center dot 4%; 1 center dot 9- 27 center dot 3) of 32 unvaccinated patients in the omicron phase had sequelae. Patients who received a booster and those who received two vaccine doses had a significantly lower prevalence of overall COVID-19 sequelae than unvaccinated or partially vaccinated patients (ten [7 center dot 4%; 95% CI 3 center dot 5-13 center dot 5] of 136 boosted patients, 18 [9 center dot 8%; 5 center dot 8-15 center dot 5] of 183 patients who had two vaccine doses vs 277 [ 18 center dot 5%; 16 center dot 5-20 center dot 9] of 1489 unvaccinated patients, p=0 center dot 0001), respiratory sequelae (six [4 center dot 4%; 1 center dot 6-9 center dot 6], 11 [6 center dot 0%; 3 center dot 0-10 center dot 7] vs 148 [9 center dot 9%; 8 center dot 4- 11 center dot 6], p= 0 center dot 030), and prolonged fatigue (three [2 center dot 2%; 0 center dot 1-6 center dot 4], ten [5 center dot 4%; 2 center dot 6-10 center dot 0] vs 115 [7 center dot 7%; 6 center dot 3-9 center dot 3], p=0 center dot 037).

SARS-CoV-2 omicron (B.1.1.529)-related COVID-19 sequelae in vaccinated and unvaccinated patients with cancer: results from the OnCovid registry / Cortellini, Alessio; Tabernero, Josep; Mukherjee, Uma; Salazar, Ramon; Sureda, Anna; Maluquer, Clara; Ferrante, Daniela; Bower, Mark; Sharkey, Rachel; Mirallas, Oriol; Plaja, Andrea; Cucurull, Marc; Mesia, Ricard; Dalla Pria, Alessia; Newsom-Davis, Thomas; Van Hemelrijck, Mieke; Sita-Lumsden, Ailsa; Apthorp, Eleanor; Vincenzi, Bruno; Di Fazio, Giuseppina Rita; Tonini, Giuseppe; Pantano, Francesco; Bertuzzi, Alexia; Rossi, Sabrina; Brunet, Joan; Lambertini, Matteo; Pedrazzoli, Paolo; Biello, Federica; D'Avanzo, Francesca; Lee, Alvin J X; Shawe-Taylor, Marianne; Rogers, Lucy; Murphy, Cian; Cooper, Lee; Andaleeb, Ramis; Khalique, Saira; Bawany, Samira; Ahmed, Sarah; Carmona-García, M Carmen; Fort-Culillas, Roser; Liñan, Raquel; Zoratto, Federica; Rizzo, Gianpiero; Perachino, Marta; Doonga, Kris; Gaidano, Gianluca; Bruna, Riccardo; Patriarca, Andrea; Martinez-Vila, Clara; Pérez Criado, Ignacio; Giusti, Raffaele; Mazzoni, Francesca; Antonuzzo, Lorenzo; Santoro, Armando; Parisi, Alessandro; Queirolo, Paola; Aujayeb, Avinash; Rimassa, Lorenza; Diamantis, Nikolaos; Bertulli, Rossella; Fulgenzi, Claudia A M; D'Alessio, Antonio; Ruiz-Camps, Isabel; Saoudi-Gonzalez, Nadia; Garcia Illescas, David; Medina, Irene; Fox, Laura; Gennari, Alessandra; Aguilar-Company, Juan; Pinato, David J. - In: THE LANCET ONCOLOGY. - ISSN 1470-2045. - ELETTRONICO. - 24:(2023), pp. 4.335-4.346. [10.1016/S1470-2045(23)00056-6]

SARS-CoV-2 omicron (B.1.1.529)-related COVID-19 sequelae in vaccinated and unvaccinated patients with cancer: results from the OnCovid registry

Mazzoni, Francesca;Antonuzzo, Lorenzo;
2023

Abstract

Background COVID-19 sequelae can affect about 15% of patients with cancer who survive the acute phase of SARS-CoV-2 infection and can substantially impair their survival and continuity of oncological care. We aimed to investigate whether previous immunisation affects long-term sequelae in the context of evolving variants of concern of SARS-CoV-2. Methods OnCovid is an active registry that includes patients aged 18 years or older from 37 institutions across Belgium, France, Germany, Italy, Spain, and the UK with a laboratory-confirmed diagnosis of COVID-19 and a history of solid or haematological malignancy, either active or in remission, followed up from COVID-19 diagnosis until death. We evaluated the prevalence of COVID-19 sequelae in patients who survived COVID-19 and underwent a formal clinical reassessment, categorising infection according to the date of diagnosis as the omicron (B.1.1.529) phase from Dec 15, 2021, to Jan 31, 2022; the alpha (B.1.1.7)-delta (B.1.617.2) phase from Dec 1, 2020, to Dec 14, 2021; and the pre-vaccination phase from Feb 27 to Nov 30, 2020. The prevalence of overall COVID-19 sequelae was compared according to SARS-CoV-2 immunisation status and in relation to post-COVID-19 survival and resumption of systemic anticancer therapy. This study is registered with ClinicalTrials.gov, NCT04393974. Findings At the follow-up update on June 20, 2022, 1909 eligible patients, evaluated after a median of 39 days (IQR 24-68) from COVID-19 diagnosis, were included (964 [ 50 center dot 7%] of 1902 patients with sex data were female and 938 [49 center dot 3%] were male). Overall, 317 (16 center dot 6%; 95% CI 14 center dot 8-18 center dot 5) of 1909 patients had at least one sequela from COVID-19 at the first oncological reassessment. The prevalence of COVID-19 sequelae was highest in the prevaccination phase (191 [19 center dot 1%; 95% CI 16 center dot 4-22 center dot 0] of 1000 patients). The prevalence was similar in the alpha-delta phase (110 [16 center dot 8%; 13 center dot 8- 20 center dot 3] of 653 patients, p=0 center dot 24), but significantly lower in the omicron phase (16 [6 center dot 2%; 3 center dot 5-10 center dot 2] of 256 patients, p<0 center dot 0001). In the alpha- delta phase, 84 (18 center dot 3%; 95% CI 14 center dot 6-22 center dot 7) of 458 unvaccinated patients and three (9 center dot 4%; 1 center dot 9- 27 center dot 3) of 32 unvaccinated patients in the omicron phase had sequelae. Patients who received a booster and those who received two vaccine doses had a significantly lower prevalence of overall COVID-19 sequelae than unvaccinated or partially vaccinated patients (ten [7 center dot 4%; 95% CI 3 center dot 5-13 center dot 5] of 136 boosted patients, 18 [9 center dot 8%; 5 center dot 8-15 center dot 5] of 183 patients who had two vaccine doses vs 277 [ 18 center dot 5%; 16 center dot 5-20 center dot 9] of 1489 unvaccinated patients, p=0 center dot 0001), respiratory sequelae (six [4 center dot 4%; 1 center dot 6-9 center dot 6], 11 [6 center dot 0%; 3 center dot 0-10 center dot 7] vs 148 [9 center dot 9%; 8 center dot 4- 11 center dot 6], p= 0 center dot 030), and prolonged fatigue (three [2 center dot 2%; 0 center dot 1-6 center dot 4], ten [5 center dot 4%; 2 center dot 6-10 center dot 0] vs 115 [7 center dot 7%; 6 center dot 3-9 center dot 3], p=0 center dot 037).
2023
24
335
346
Cortellini, Alessio; Tabernero, Josep; Mukherjee, Uma; Salazar, Ramon; Sureda, Anna; Maluquer, Clara; Ferrante, Daniela; Bower, Mark; Sharkey, Rachel; Mirallas, Oriol; Plaja, Andrea; Cucurull, Marc; Mesia, Ricard; Dalla Pria, Alessia; Newsom-Davis, Thomas; Van Hemelrijck, Mieke; Sita-Lumsden, Ailsa; Apthorp, Eleanor; Vincenzi, Bruno; Di Fazio, Giuseppina Rita; Tonini, Giuseppe; Pantano, Francesco; Bertuzzi, Alexia; Rossi, Sabrina; Brunet, Joan; Lambertini, Matteo; Pedrazzoli, Paolo; Biello, Federica; D'Avanzo, Francesca; Lee, Alvin J X; Shawe-Taylor, Marianne; Rogers, Lucy; Murphy, Cian; Cooper, Lee; Andaleeb, Ramis; Khalique, Saira; Bawany, Samira; Ahmed, Sarah; Carmona-García, M Carmen; Fort-Culillas, Roser; Liñan, Raquel; Zoratto, Federica; Rizzo, Gianpiero; Perachino, Marta; Doonga, Kris; Gaidano, Gianluca; Bruna, Riccardo; Patriarca, Andrea; Martinez-Vila, Clara; Pérez Criado, Ignacio; Giusti, Raffaele; Mazzoni, Francesca; Antonuzzo, Lorenzo; Santoro, Armando; Parisi, Alessandro; Queirolo, Paola; Aujayeb, Avinash; Rimassa, Lorenza; Diamantis, Nikolaos; Bertulli, Rossella; Fulgenzi, Claudia A M; D'Alessio, Antonio; Ruiz-Camps, Isabel; Saoudi-Gonzalez, Nadia; Garcia Illescas, David; Medina, Irene; Fox, Laura; Gennari, Alessandra; Aguilar-Company, Juan; Pinato, David J
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