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感染冠状病毒的肿瘤患者的预后

Outcome of Oncology Patients Infected With Coronavirus.

作者信息

Jazieh Abdul-Rahman, Alenazi Thamer H, Alhejazi Ayman, Al Safi Faisal, Al Olayan Ashwaq

机构信息

Department of Oncology, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.

出版信息

JCO Glob Oncol. 2020 Mar;6:471-475. doi: 10.1200/GO.20.00064.

Abstract

PURPOSE

This study investigated the features of oncology patients with confirmed Middle East respiratory syndrome (MERS) at the Ministry of National Guard Health Affairs-Riyadh during the outbreak of June 2015 to determine the clinical course and outcome of affected patients.

METHODS

The patients' demographic information, cancer history, treatment pattern, information about MERS-coronavirus (CoV) infection, history of travel, clinical symptoms, test results, and outcome were collected and analyzed as part of a quality improvement project to improve the care and safety of our patients. Only patients with confirmed infection were included.

RESULTS

A total of 19 patients were identified, with a median age of 66 years (range, 16-88 years), and 12 patients (63%) were males. The most common underlying disease was hematologic malignancies (47.4%), followed by colorectal cancer (21%) and lung cancer (15.8%). Hypertension and diabetes mellitus were the most common comorbidities (57.9% and 52.6%, respectively). Infection was diagnosed by nasopharyngeal swab in all patients. All patients contracted the infection during their hospitalization for other reasons. Sixteen patients (80%) were admitted to the intensive care unit; 13 patients (81%) had acute respiratory distress syndrome, 11 were intubated (68.75%), 9 had acute renal injury (56.25%), and 3 required dialysis (18.75%). Only 3 patients (15.8%) with early-stage cancers survived. Patients with hematologic malignancies and advanced solid tumors had a 100% case fatality rate. The majority of the causes of death were due to multi-organ failure and septic shock.

CONCLUSION

MERS-CoV infection resulted in a high case fatality rate in patients with malignancy. Therefore, it is critical to implement effective primary preventive measures to avoid exposure of patients with cancer to the virus.

摘要

目的

本研究调查了2015年6月疫情爆发期间利雅得国民卫队卫生事务部确诊感染中东呼吸综合征(MERS)的肿瘤患者的特征,以确定受影响患者的临床病程和结局。

方法

收集患者的人口统计学信息、癌症病史、治疗模式、中东呼吸综合征冠状病毒(MERS-CoV)感染信息、旅行史、临床症状、检测结果和结局,并作为一项质量改进项目的一部分进行分析,以改善我们患者的护理和安全。仅纳入确诊感染的患者。

结果

共确定19例患者,中位年龄66岁(范围16 - 88岁),12例(63%)为男性。最常见的基础疾病是血液系统恶性肿瘤(47.4%),其次是结直肠癌(21%)和肺癌(15.8%)。高血压和糖尿病是最常见的合并症(分别为57.9%和52.6%)。所有患者均通过鼻咽拭子确诊感染。所有患者均因其他原因住院期间感染。16例患者(80%)入住重症监护病房;13例患者(81%)发生急性呼吸窘迫综合征,11例接受插管(68.75%),9例发生急性肾损伤(56.25%),3例需要透析(18.75%)。仅3例早期癌症患者存活。血液系统恶性肿瘤和晚期实体瘤患者的病死率为100%。大多数死亡原因是多器官功能衰竭和感染性休克。

结论

MERS-CoV感染导致恶性肿瘤患者病死率很高。因此,实施有效的一级预防措施以避免癌症患者接触该病毒至关重要。

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