COVID-19 Enfeksiyonu Sonrası Kanser Hastalarında Uzun Süreli Sağkalım: İnflamatuar İndekslerin Ve Aşılama Durumunun Prognostik Değeri

Abstract

Coronavirus Disease 2019 (COVID-19) enfeksiyonuna maruz kalan kanser hastalarının sağkalım sonuçları, enfeksiyon sonrası tedaviye yeniden başlama süresi ve malignitelerinin seyri hakkındaki veriler kısıtlıdır. Bu retrospektif çalışmada, Nisan 2020 ile Ekim 2023 tarihleri arasında merkezimizde COVID-19 nedeniyle yatarak tedavi gören 128 kanser hastası değerlendirilmiştir. Hastaların %39,8'i kadın, %60,2'si erkekti. Akut enfeksiyon sürecinde metastatik akciğer tutulumu olan hastaların, olmayanlara göre 3,34 kat daha yüksek ölüm riski taşıdığı saptanmıştır. Post-COVID sağkalım kohortunda yapılan çok değişkenli analizde; daha genç yaş, daha yüksek hemoglobin düzeyi, daha yüksek sistemik inflamatuvar indeks, daha düşük pan-immün inflamasyon değeri ve aktif kanser bulunmaması daha uzun sağkalım ile ilişkili bulunmuştur. Ayrıca aşı tipine bağlı sağkalım farklılıkları gözlenmiştir; ancak bu bulguların belirli aşı tiplerinin yüksek riskli hastalara öncelikli olarak uygulanması gibi karıştırıcı faktörleri yansıtma olasılığı nedeniyle doğrudan nedensel bir ilişkiyi göstermediği ve bu nedenle temkinli yorumlanması gerektiği düşünülmektedir. Çalışmanın ayırt edici özelliği olan uzun süreli takip sonucunda, progresyon gösteren hastalarda tedavi gecikmeleri yaygın görülse de bu gecikmelerin genel sağkalım üzerinde istatistiksel olarak anlamlı bir fark yaratmadığı belirlenmiştir.

Keywords

• COVID-19
• Neoplasms
• RNA Vaccines
• Inflammation
• Time-to-treatment
• Post-acute COVID-19 Syndrome

Long-Term Survival of Cancer Patients Following COVID-19 Infection: Prognostic Value of Inflammatory Indices and Vaccination Status

Abstract

The survival outcomes of cancer patients exposed to Coronavirus Disease 2019 (COVID-19), the duration required to resume oncological treatment, and the subsequent course of their malignancy remain areas with limited data. This retrospective study evaluated 128 cancer patients hospitalized for COVID-19 treatment between April 2020 and October 2023. Of the cohort, 39.8% were women and 60.2% were men. Findings revealed that patients with metastatic lung involvement faced a 3.34-fold increased risk of death during the acute infection. In the post-COVID survival cohort, multivariate analysis indicated that younger age, higher hemoglobin levels, higher systemic inflammatory index, lower pan-immune inflammation value, and absence of active cancer were associated with longer survival. Additionally, vaccine-related survival differences were observed; however, these findings should be interpreted cautiously as they likely reflect confounding factors such as prioritizing high-risk patients for certain vaccine types rather than a direct causal relationship. Notably, while treatment delays were common among patients with disease progression, these delays did not result in a statistically significant difference in overall survival during the long-term follow-up.

Keywords

• COVID-19
• Neoplasms
• RNA Vaccines
• Inflammation
• Time-to-treatment
• Post-acute COVID-19 Syndrome

References

1. 1. World Health Organization. Coronavirus disease (COVID-2019) situation reports. Accessed February 6, 2026. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
2. 2. Aboueshia M, Hussein MH, Attia AS, et al. Cancer and COVID-19: analysis of patient outcomes. Future Oncol. 2021;17(26):3499-3510.
3. 3. Grivas P, Khaki AR, Wise-Draper TM, et al. Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium. Ann Oncol. 2021;32(6):787–800.
4. 4. Ozer M, Goksu SY, Mahdi M, Gandhi N. Characteristics and outcomes of cancer patients with covid-19 at a safety-net hospital. Cancer Treat Res Commun. 2021;28:100418.
5. 5. Lee LY, Cazier JB, Angelis V, et al. COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study. Lancet. 2020;395(10241):1919-1926.
6. 6. Miaskowski C, Paul SM, Snowberg K, et al. Oncology patients’ perceptions of and experiences with COVID-19. Support Care Cancer. 2021;29(4):1941-1950.
7. 7. Wang Q, Berger NA, Xu R. Analyses of risk, racial disparity, and outcomes among US patients with cancer and COVID-19 infection. JAMA Oncol. 2021;7(2):220-227.
8. 8. Madan A, Siglin J, Khan A. Comprehensive review of implications of COVID‐19 on clinical outcomes of cancer patients and management of solid tumors during the pandemic. Cancer Med. 2020;9(24):9205-9218.

9. 9. Rubio MC, Sanchez L, Abreu-Ruíz G, Bermejo-Bencomo W, Crombet T, Lage A. COVID-19 and cancer in Cuba. Semin Oncol. 2020;47(5):328-329.
10. 10. Kim YJ, Lee ES, Lee YS. High mortality from viral pneumonia in patients with cancer. Infect Dis (Lond). 2019;51(7):502-509.
11. 11. Zhang F, Li T, Bai Y, et al. Treatment strategies with combined agency against severe viral pneumonia in patients with cancer. J Transl Int Med. 2024;12(3):317-320.
12. 12. Guo M, Shang S, Li M, et al. Understanding autoimmune response after SARS-CoV-2 infection and the pathogenesis/mechanisms of long COVID. Med Rev. 2024;4(5):367-383.
13. 13. Ewing AG, Salamon S, Pretorius E, et al. Review of organ damage from COVID and Long COVID: a disease with a spectrum of pathology. Med Rev. 2025;5(1):66-75.
14. 14. Knight K, Wade S, Balducci L. Prevalence and outcomes of anemia in cancer: a systematic review of the literature. Am J Med. 2004;116(7 Suppl 1):11-26.
15. 15. Guven DC, Sahin TK, Erul E, Kilickap S, Gambichler T, Aksoy S. The association between the pan-immune-inflammation value and cancer prognosis: a systematic review and meta-analysis. Cancers (Basel). 2022;14(11):2675.
16. 16. Haemmerle M, Taylor ML, Gutschner T, et al. Platelets reduce anoikis and promote metastasis by activating YAP1 signaling. Nat Commun. 2017;8(1):310.
17. 17. Fucà G, Guarini V, Antoniotti C, et al. The pan-immune-inflammation value is a new prognostic biomarker in metastatic colorectal cancer: results from a pooled analysis of the Valentino and TRIBE first-line trials. Br J Cancer. 2020;123(3):403-409. doi:10.1038/s41416-020-0894-7.
18. 18. Kitamura T, Qian BZ, Pollard JW. Immune cell promotion of metastasis. Nat Rev Immunol. 2015;15(2):73-86. doi:10.1038/nri3789.
19. 19. Brambilla M, Canzano P, Della Valle P, et al. Head-to-head comparison of four COVID-19 vaccines on platelet activation, coagulation and inflammation. The TREASURE study. Thromb Res. 2023;223:24-33.
20. 20. Terentes-Printzios D, Gardikioti V, Solomou E, et al. The effect of an mRNA vaccine against COVID-19 on endothelial function and arterial stiffness. Hypertens Res. 2022;45(5):846-855.