Long COVID Risk May Be Especially High for Cancer Patients

Many cancer patients who are infected with COVID-19 are left with lingering symptoms.

A new study, published Feb. 7 in eLife, found that more than half of cancer patients develop long COVID, and women were especially at risk.

“Although cancer patients fall into a higher COVID-19 risk group there is limited data on PASC in cancer patients and how it affects their progression, care and treatment,” said lead author Dr. Anne-Marie Chaftari, an associate professor of infectious diseases at the University of Texas MD Anderson Cancer Center in Houston.

“In order to provide a better understanding of post-COVID-19 management among cancer patients, we sought to characterize the patterns of long COVID-19 specifically in these patients,” Chaftari said in a journal news release.

Researchers noted their findings are comparable to reported cases of long COVID in the general population. Reports of long COVID prevalence vary from 10% to 87%.

For the study, the researchers followed patients at the cancer center who were diagnosed with COVID between March and September of 2020. They were followed for up to 14 months.

Patients were asked to record symptoms including fatigue, cough, chest tightness, difficulty breathing, headache, fever, altered sense of smell or taste, muscle aches, gastrointestinal symptoms, sleep disturbance and any limitations with daily activities.

Symptoms that continued beyond 30 days after severe initial symptoms or hospitalization were considered long COVID.

Data from 312 cancer patients showed 60% developed long COVID.

Those who had relapsed or had treatment-resistant cancer at the start and those who had more severe acute COVID infections were less likely to develop long COVID.

Female patients had a higher rate of long COVID than men, 63% compared to 51%.

Other risk factors, such as depleted white blood cells, needing oxygen, being hospitalized for COVID or multi-organ failure, were similar among those with long COVID and patients who did not have it.

Patients with long COVID most often experienced fatigue, sleep disturbances, muscle pain and GI symptoms.

Those with high blood pressure were less likely to develop long COVID, researchers noted.

This surprised researchers, because high blood pressure is a known risk factor for more severe acute COVID. A similar finding was seen in another study of long-COVID in immunocompromised patients, they noted.

The authors said the link between high blood pressure and severe COVID risk is thought to be due to the binding of the SARS-CoV-2’s spike protein to an enzyme that is the target of many medications that lower high blood pressure. They said these findings might rule out this mechanism being important for the development of long COVID.

Among cancer patients who developed long COVID, 59 were readmitted to the hospital, though only 16 were admitted related to COVID. Most had symptoms that could be managed by outpatient care.

“Our study found that long COVID-19 occurred in the majority of our cancer patients and was more prevalent in women than men,” said senior author Dr. Issam Raad, a professor of infectious diseases at MD Anderson Cancer Center.

“Even in this high-risk patient population, long COVID-19 was not associated with a high rate of hospital admissions,” Raad said in the release. “We also found no underlying condition or severity of illness during acute COVID-19 that would predict long COVID-19.”

More information

The U.S. National Institutes of Health has more on long COVID.

SOURCE: eLife, news release, Feb. 7, 2023

Source: HealthDay