COVID-19 Sequelae and the Host Proinflammatory Response: An Analysis From the OnCovid Registry

Cortellini, Alessio; Gennari, Alessandra; Pommeret, Fanny; Patel, Grisma; Newsom-Davis, Thomas; Bertuzzi, Alexia; Viladot, Margarita; Aguilar-Company, Juan; Mirallas, Oriol; Felip, E.; Lee, Alvin; Pria, Alessia Dalla; Sharkey, Rachel; Brunet, Joan; Carmona-García, M Carmen; Chester, John D.; Mukherjee, Uma; Scotti, Lorenza; Dolly, Saoirse; Sita‐Lumsden, Ailsa; Ferrante, Daniela; Hemelrijck, Mieke Van; Moss, Charlotte; Russell, Beth; Seguí, Elia; Biello, Federica; Krengli, Marco; Marco-Hernández, Javier; Gaïdano, Gianluca; Patriarca, Andrea; Bruna, Riccardo; Roldán, Elisa; Fox, Laura; Pous, Anna; Griscelli, Franck; Salazar, Ramón; Martínez-Vila, Clara; Sureda, Anna; Loizidou, Angela; Maluquer, Clara; Stoclin, Annabelle; Iglesias, María; Pedrazzoli, Paolo; Rizzo, Gianpiero; Santoro, Armando; Rimassa, Lorenza; Rossi, Sabrina; Harbeck, Nadia; Torre, Ana Sánchez de; Vincenzi, Bruno; Libertini, Michela; Provenzano, Salvatore; Generali, Daniele; Grisanti, Salvatore; Berardi, Rossana; Tucci, Marco; Mazzoni, Francesca; Lambertini, Matteo; Tagliamento, Marco; Parisi, Alessandro; Zoratto, Federica; Queirolo, Paola; Giusti, Raffaele; Guida, Annalisa; Zambelli, Alberto; Tondini, Carlo; Maconi, Antonio; Betti, Marta; Colomba, Emeline; Diamantis, Nikolaos; Sinclair, Alasdair; Bower, Mark; Ruiz‐Camps, Isabel; Pinato, David J.; Hanbury, Georgina; Chung, Chris; Patel, Meera; Dettorre, Gino M; Sng, Christopher C.T.; Yu, Tamara; Shawe-Taylor, Marianne; Bain, Hamish DC; Cooper, Lee; Rogers, Lucy; Belessiotis, Katherine; Murphy, Cian; Bawany, Samira; Khalique, Saira; Andaleeb, Ramis; Apthorp, Eleanor; Reyes, Roxana; García-Illescas, David; Saoudi, Nadia; Lloveras, Ariadna Roqué; Mesı́a, Ricard; Plaja, Andrea; Cucurull, Marc; Grosso, Federica; Fusco, Vittorio; Baggi, Alice; Saponara, Maristella; Cantini, Luca

doi:10.1093/jnci/djac057

Cited by 18 publications

(25 citation statements)

References 37 publications

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“…Patients' observation time started from the date of first SARS-CoV-2 infection confirmation until patient' death or loss to follow-up. Clinical information of patients who survived COVID-19 and were subsequently followed at the participating institutions according to local practice are regularly entered the registry in the context of the post-COVID-19 follow-up analysis [14][15][16].…”

Section: Methodsmentioning

confidence: 99%

Natural immunity to SARS-CoV-2 and breakthrough infections in vaccinated and unvaccinated patients with cancer

et al. 2022

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Background Consolidated evidence suggests spontaneous immunity from SARS-CoV-2 is not durable, leading to the risk of reinfection, especially in the context of newly emerging viral strains. In patients with cancer who survive COVID-19 prevalence and severity of SARS-CoV-2 reinfections are unknown. Methods We aimed to document natural history and outcome from SARS-CoV-2 reinfection in patients recruited to OnCovid (NCT04393974), an active European registry enrolling consecutive patients with a history of solid or haematologic malignancy diagnosed with COVID-19. Results As of December 2021, out of 3108 eligible participants, 1806 COVID-19 survivors were subsequently followed at participating institutions. Among them, 34 reinfections (1.9%) were reported after a median time of 152 days (range: 40–620) from the first COVID-19 diagnosis, and with a median observation period from the second infection of 115 days (95% CI: 27–196). Most of the first infections were diagnosed in 2020 (27, 79.4%), while most of reinfections in 2021 (25, 73.5%). Haematological malignancies were the most frequent primary tumour (12, 35%). Compared to first infections, second infections had lower prevalence of COVID-19 symptoms (52.9% vs 91.2%, P = 0.0008) and required less COVID-19-specific therapy (11.8% vs 50%, P = 0.0013). Overall, 11 patients (32.4%) and 3 (8.8%) were fully and partially vaccinated against SARS-CoV-2 before the second infection, respectively. The 14-day case fatality rate was 11.8%, with four death events, none of which among fully vaccinated patients. Conclusion This study shows that reinfections in COVID-19 survivors with cancer are possible and more common in patients with haematological malignancies. Reinfections carry a 11% risk of mortality, which rises to 15% among unvaccinated patients, highlighting the importance of universal vaccination of patients with cancer.

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Section: Methodsmentioning

confidence: 99%

Natural immunity to SARS-CoV-2 and breakthrough infections in vaccinated and unvaccinated patients with cancer

et al. 2022

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“…The prolonged use of glucocorticoids for post‐pneumonia treatment might re‐active the tuberculosis. Patients who received chemotherapy weeks after the diagnosis of COVID‐19 seemed to have a decrease rate of developing sequelae, compared with patients without tumors 128 . It was postulated that chemotherapy might reduce the unopposed pro‐inflammatory signal.…”

Section: Manifestations Of Long Covid In Multiple Organsmentioning

confidence: 99%

“…Patients who received chemotherapy weeks after the diagnosis of COVID‐19 seemed to have a decrease rate of developing sequelae, compared with patients without tumors. 128 It was postulated that chemotherapy might reduce the unopposed pro‐inflammatory signal. Interestingly, the risk of long COVID in cancer patients decreased with age, which also suggests that immunosuppression caused by chemotherapy may work together with the senescence of immune system to protect against the pro‐inflammatory signals.…”

Section: Manifestations Of Long Covid In Multiple Organsmentioning

confidence: 99%

Long COVID: The latest manifestations, mechanisms, and potential therapeutic interventions

Cheng

et al. 2022

MedComm

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COVID‐19 caused by SARS‐CoV‐2 infection affects humans not only during the acute phase of the infection, but also several weeks to 2 years after the recovery. SARS‐CoV‐2 infects a variety of cells in the human body, including lung cells, intestinal cells, vascular endothelial cells, olfactory epithelial cells, etc. The damages caused by the infections of these cells and enduring immune response are the basis of long COVID. Notably, the changes in gene expression caused by viral infection can also indirectly contribute to long COVID. We summarized the occurrences of both common and uncommon long COVID, including damages to lung and respiratory system, olfactory and taste deficiency, damages to myocardial, renal, muscle, and enduring inflammation. Moreover, we provided potential treatments for long COVID symptoms manifested in different organs and systems, which were based on the pathogenesis and the associations between symptoms in different organs. Importantly, we compared the differences in symptoms and frequency of long COVID caused by breakthrough infection after vaccination and infection with different variants of concern, in order to provide a comprehensive understanding of the characteristics of long COVID and propose improvement for tackling COVID‐19.

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“…As of middle April, 2022, more than 500 million COVID-19 cases have been confirmed, and more than 6.1 million people have died globally [4]. In the general population, between 13 and 60% of COVID-19 survivors are at risk of developing post COVID-19 symptoms [5].A wide variety of COVID-19 sequelae have been described, including respiratory symptoms, gastrointestinal sequelae, functional impairment, neuro-cognitive changes and urological symptoms [5][6][7][8][9][10][11][12].The patients with SARS suffer from many physical and psychological problems even after 1-3 years of being discharged from the hospital [13][14][15][16][17][18]. In COVID-19 survivors, many mental health issues also existed after hospital discharge, such as fatigue, insomnia, decreased quality of life, anxiety, depression, and PTSD [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional study on the mental health of patients with COVID-19 1 year after discharge in Huanggang, China

Wang

et al. 2022

Eur Arch Psychiatry Clin Neurosci

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Objective This study is aimed to investigate the mental health status of COVID-19 survivors 1 year after discharge from hospital and reveal the related risk factors. Methods From April 11 to May 11, 2021, 566 COVID-19 survivors in Huanggang city were recruited through their primary doctors. A total of 535 participants (94.5%) admitted to participate in the survey and completed the questionnaires. Five scales were applied including 7-Items Generalized Anxiety Disorder Scale, Patient Health Questionnaire-9, Impact of Event Scale-Revised, Pittsburgh Sleep Quality Index, and Fatigue Scale-14. The chi-square and the Fisher’s exact test were used to evaluate the classification data, multivariate logistic regression was used to explore the related factors of sleep quality, fatigue, anxiety, depression, and post-traumatic stress disorder (PTSD). Results One year after being discharged, of the 535 COVID-19 survivors, 252 (47.1%) had poor sleep quality; 157 (29.3%) had the symptoms of fatigue; 84 (15.7%),112 (20.9%), and 130 (24.3%) suffered from symptoms of anxiety, depression, and PTSD, respectively. The logistic regression analysis showed that history of chronic disease was risk factor for poor sleep quality (OR 2.501; 95% CI, 1.618–3.866), fatigue (OR 3.284; 95% CI 2.143–5.033), PTSD (OR 2.323; 95% CI 1.431–3.773) and depression (OR 1.950; 95% CI 1.106–3.436) in COVID-19 survivors. Smoking contributed to the poor sleep quality (OR 2.005; 95% CI 1.044–3.850), anxiety (OR 4.491; 95% CI 2.276–8.861) and depression (OR 5.459; 95% CI 2.651–11.239) in survivors. Drinking influenced fatigue (OR 2.783; 95% CI 1.331–5.819) and PTSD (OR 4.419; 95% CI 1.990–9.814) in survivors. Compared with college-educated survivors, survivors with high school education were at higher risk for poor sleep quality (OR 1.828; 95% CI 1.050–3.181) and PTSD (OR 2.521; 95% CI 1.316–4.830), and survivors with junior high school education were at higher risk for PTSD (OR 2.078; 95% CI 1.039–4.155). Compared with overweight survivors (BMI ≥ 23.0), survivors with normal BMI (18.5–22.9) (OR 0.600; 95% CI 0.405–0.889) were at lower risk for fatigue. While being housewife (OR 0.390; 95% CI 0.189–0.803) was protective factor for fatigue and having more family members was protective factor for PTSD (OR 0.404 95% CI 0.250–0.653) in survivors. Conclusions One year after infection, poor sleep quality, fatigue, anxiety, depression, and PTSD, still existed in a relatively high proportion of COVID-19 survivors. Chronic disease history was an independent risk factor for poor sleep quality, fatigue, depression, and PTSD. Participants with low education levels were more likely to have mental problems than the others. We should focus on the long-term psychological impact of COVID-19 on survivors, and the government should apply appropriate mental health services to offer psychiatric support. Supplementary Information The online version con...

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COVID-19 Sequelae and the Host Proinflammatory Response: An Analysis From the OnCovid Registry

Cited by 18 publications

References 37 publications

Natural immunity to SARS-CoV-2 and breakthrough infections in vaccinated and unvaccinated patients with cancer

Natural immunity to SARS-CoV-2 and breakthrough infections in vaccinated and unvaccinated patients with cancer

Long COVID: The latest manifestations, mechanisms, and potential therapeutic interventions

A cross-sectional study on the mental health of patients with COVID-19 1 year after discharge in Huanggang, China

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