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COVID-19 与血液系统恶性肿瘤。

COVID-19 in persons with haematological cancers.

机构信息

Institute of Haematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Department of Haematology, Wuhan Central Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Leukemia. 2020 Jun;34(6):1637-1645. doi: 10.1038/s41375-020-0836-7. Epub 2020 Apr 24.

Abstract

Infection with SARS-CoV-2, the cause of coronavirus infectious disease-19 (COVID-19), has caused a pandemic with >850,000 cases worldwide and increasing. Several studies report outcomes of COVID-19 in predominately well persons. There are also some data on COVID-19 in persons with predominately solid cancer but controversy whether these persons have the same outcomes. We conducted a cohort study at two centres in Wuhan, China, of 128 hospitalised subjects with haematological cancers, 13 (10%) of whom developed COVID-19. We also studied 226 health care providers, 16 of whom developed COVID-19 and 11 of whom were hospitalised. Co-variates were compared with the 115 subjects with haematological cancers without COVID-19 and with 11 hospitalised health care providers with COVID-19. There were no significant differences in baseline co-variates between subjects with haematological cancers developing or not developing COVID-19. Case rates for COVID-19 in hospitalised subjects with haematological cancers was 10% (95% Confidence Interval [CI], 6, 17%) compared with 7% (4, 12%; P = 0.322) in health care providers. However, the 13 subjects with haematological cancers had more severe COVID-19 and more deaths compared with hospitalised health care providers with COVID-19. Case fatality rates were 62% (32, 85%) and 0 (0, 32%; P = 0.002). Hospitalised persons with haematological cancers have a similar case rate of COVID-19 compared with normal health care providers but have more severe disease and a higher case fatality rate. Because we were unable to identify specific risk factors for COVID-19 in hospitalised persons with haematological cancers, we suggest increased surveillance and possible protective isolation.

摘要

感染 SARS-CoV-2 是导致冠状病毒病 19 型(COVID-19)的原因,已在全球范围内造成超过 85 万例病例,并呈上升趋势。有几项研究报告了 COVID-19 在主要为健康人群中的结局。也有一些关于 COVID-19 在主要为实体癌患者中的数据,但存在争议,即这些患者是否具有相同的结局。我们在中国武汉的两个中心进行了一项队列研究,纳入了 128 例住院血液系统癌症患者,其中 13 例(10%)发生了 COVID-19。我们还研究了 226 名卫生保健工作者,其中 16 例发生了 COVID-19,11 例住院。将协变量与 115 例未发生 COVID-19 的血液系统癌症患者和 11 例住院 COVID-19 卫生保健工作者进行比较。发生或未发生 COVID-19 的血液系统癌症患者在基线协变量方面无显著差异。住院血液系统癌症患者的 COVID-19 发生率为 10%(95%置信区间 [CI],6 至 17%),而住院 COVID-19 卫生保健工作者的发生率为 7%(4 至 12%;P=0.322)。然而,13 例血液系统癌症患者的 COVID-19 更严重,且死亡人数多于住院 COVID-19 卫生保健工作者。病死率分别为 62%(32 至 85%)和 0(0 至 32%;P=0.002)。与正常卫生保健工作者相比,住院血液系统癌症患者的 COVID-19 发病率相似,但疾病更严重,病死率更高。由于我们无法确定住院血液系统癌症患者发生 COVID-19 的具体危险因素,因此建议加强监测并可能进行保护性隔离。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aee1/7180672/5ba0d4b70aec/41375_2020_836_Fig1_HTML.jpg

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