Ke Zhou1, Audrey Blanc-Lapierre2, Valérie Seegers2, Michèle Boisdron-Celle3, Frédéric Bigot4, Marianne Bourdon1,5, Hakim Mahammedi6, Aurélien Lambert7, Mario Campone8, Thierry Conroy7, Frédérique Penault-Llorca9, Martine M Bellanger1,10, Jean-Luc Raoul8. 1. Department of Human and Social Sciences, Institut de Cancérologie de l'Ouest (ICO), 44805 Saint-Herblain, France. 2. Department of Biostatistic, Institut de Cancérologie de l'Ouest, 44805 Saint-Herblain, France. 3. Department of Biopathology, Institut de Cancérologie de l'Ouest, 49055 Angers, France. 4. Department of Medical Oncology, Institut de Cancérologie de l'Ouest, 49055 Angers, France. 5. Research Unit UMR INSERM 1246 SPHERE, Universités de Nantes et Tours, 44035 Nantes, France. 6. Department of Medical Oncology, Centre Jean Perrin, 63011 Clermont-Ferrand, France. 7. Department of Medical Oncology, Institut de Cancérologie de Lorraine, 54511 Vandoeuvre-lès-Nancy, France. 8. Department of Medical Oncology, Institut de Cancérologie de l'Ouest, 44805 Saint-Herblain, France. 9. Department of Biopathology and INSERM U1240, Centre Jean Perrin, 63011 Clermont-Ferrand, France. 10. Department of Social Sciences, EHESP School of Public Health, 35043 Rennes, France.
Abstract
Background: Cancer patients may fail to distinguish COVID-19 symptoms such as anosmia, dysgeusia/ageusia, anorexia, headache, and fatigue, which are frequent after cancer treatments. We aimed to identify symptoms associated with COVID-19 and to assess the strength of their association in cancer and cancer-free populations. Methods: The multicenter cohort study PAPESCO-19 included 878 cancer patients and 940 healthcare workers (HCWs). At baseline and quarterly thereafter, they reported the presence or absence of 13 COVID-19 symptoms observed over 3 months and the results of routine screening RT-PCR, and they were systematically tested for SARS-CoV-2-specific antibodies. We identified the symptom combinations significantly associated with COVID-19. Results: Eight percent of cancer patients were COVID-19 positive, and 32% were symptomatic. Among the HCWs, these proportions were 9.5 and 52%, respectively. Anosmia, anorexia, fever, headache, and rhinorrhea together accurately discriminated (c-statistic = 0.7027) COVID-19 cases from cancer patients. Anosmia, dysgeusia/ageusia, muscle pain, intense fatigue, headache, and chest pain better discriminated (c-statistic = 0.8830) COVID-19 cases among the HCWs. Anosmia had the strongest association in both the cancer patients (OR = 7.48, 95% CI: 2.96-18.89) and HCWs (OR = 5.71, 95% CI: 2.21-14.75). Conclusions: COVID-19 symptoms and their diagnostic performance differ in the cancer patients and HCWs. Anosmia is associated with COVID-19 in cancer patients, while dysgeusia/ageusia is not. Cancer patients deserve tailored preventive measures due to their particular COVID-19 symptom pattern.
Background: Cancerpatients may fail to distinguish COVID-19 symptoms such as anosmia, dysgeusia/ageusia, anorexia, headache, and fatigue, which are frequent after cancer treatments. We aimed to identify symptoms associated with COVID-19 and to assess the strength of their association in cancer and cancer-free populations. Methods: The multicenter cohort study PAPESCO-19 included 878 cancerpatients and 940 healthcare workers (HCWs). At baseline and quarterly thereafter, they reported the presence or absence of 13 COVID-19 symptoms observed over 3 months and the results of routine screening RT-PCR, and they were systematically tested for SARS-CoV-2-specific antibodies. We identified the symptom combinations significantly associated with COVID-19. Results: Eight percent of cancerpatients were COVID-19 positive, and 32% were symptomatic. Among the HCWs, these proportions were 9.5 and 52%, respectively. Anosmia, anorexia, fever, headache, and rhinorrhea together accurately discriminated (c-statistic = 0.7027) COVID-19 cases from cancerpatients. Anosmia, dysgeusia/ageusia, muscle pain, intense fatigue, headache, and chest pain better discriminated (c-statistic = 0.8830) COVID-19 cases among the HCWs. Anosmia had the strongest association in both the cancerpatients (OR = 7.48, 95% CI: 2.96-18.89) and HCWs (OR = 5.71, 95% CI: 2.21-14.75). Conclusions: COVID-19 symptoms and their diagnostic performance differ in the cancerpatients and HCWs. Anosmia is associated with COVID-19 in cancerpatients, while dysgeusia/ageusia is not. Cancerpatients deserve tailored preventive measures due to their particular COVID-19 symptom pattern.