ABSTRACT
Introduction: It is well known, that oncological patients need acute support adapted to their situation of disease stress (diagnosis, start or change of therapy, side efects, critical point of disease) and life stress (drop of quality of life, reduction of wellbeing, fear of existence, family concerns). COVID-19 is likely to be an additional challenge. The aim of the present study was to fnd out whether and how the pandemic further infuences the subjective experience of oncological patients in correlation to a study by the University of Innsbruck. Method(s): Evaluation with a standardized procedure and open questions (online survey;patients, control group): SoMe (Schnell & Becker, 2007);SCS-K-D (Bertrams & Dickhauser, 2009);IE-4 (Kovaleva et al 2012);PANAS-SF (Tompson 2016);PHQ4 (Lowe et al 2010);ERQ (Abler & Kessler 2011);CMQ (Bruder et al 2013);IWAH (McFarland et al 2012);questions related to COVID-19 (fear of infection, information search and opportunities);questions about understanding the pandemic and personal conclusions to go on. Result(s): The result of all evaluated people (afected group N=91, 47% female, age 20 to 80 years, M=56.22, SD=14.81;control group N=800, 77% female, age 17 to 82 years, M=32.18, SD=12.85) showed, that all patients in ongoing treatment were searching for information about the pandemic: on TV 86% (cg 61%);in newspapers 53% (cg 42%);in the internet 61% (cg 89%): ofcial channels and online newspapers 34%, google 25%. 53% of cancer patients showed fear of SARS-CoV-2 (cg 13%). Only 11% of them couldnt handle their situation in a positive way respectively couldnt stop worrying thoughts and felt depressed, 18% were afraid of the future and 67% thought that they will survive well the coming months. 38% felt externally determined and 72% felt mistreated by fate. More than the half of all patients believe in conspiracy theories, but theres no correlation between fear of infection and conspiracy belief (r=.11;p=.25) (cg r=-.06;p=.04). This fear in correlation to depression and anxiety is signifcant (r=.37;p<.001) (cg r=.20;p<.001). Conclusion(s): Our surveys show that oncological patients need targeted information and acute support to counteract stressful thoughts and to minimize the fear of losing therapy during a pandemic. Overall, it means that self-regulation, control conviction and social conclusion are benef-cial characteristics, proven for all but especially for people burdened by life-threatening diseases.
ABSTRACT
Background: Patients with haemato-oncological malignancies are one of the high-risk groups for a severe course in case of Covid-19 infections. Furthermore, vaccination results in signifcantly lower response rates in haematological malignancies and lower antibody levels in patients with solid cancer. We investigated efcacy and safety of a heterologous booster vaccination with Ad26.COV2.S DNA vector vaccine in haemato-oncological patients without antibody response after doubledose BNT162b2 mRNA Covid-19 vaccine. Methods: A total of 32 haemato-oncological non-respond-ers to double-dose BNT162b2 received a heterologous booster vaccination with Ad26.COV2.S. Blood samples were assessed directly before the vaccination (T0) and 4 weeks after (T1). Safety assessment was performed using a standardised questionnaire. Results: The overall response rate was 31 %, with a mean (SD) antibody titre of 693.79 (1096.99) BAU/ml. Patients with chronic lymphocytic leukaemia or lymphoma showed a sig-nifcantly lower response rate (P = 0.048). Adverse events were reported in 29.6 % of patients, whereby 7.1 % were graded as severe, which includes grade III and IV events following CTCAE. Conclusions: The heterologous booster vaccination with Ad26.COV2.S led to a serological response in 9 out of 29 patients without response after double-dose BNT162b2. Furthermore, the vaccination was safe in our cohort, leading to mainly mild local and systemic reactions. Overall, this vaccination regimen should be further evaluated to increase the response rate in the highly vulnerable population of haemato-oncological patients.