Infectious Diseases, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Infection Control, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Nat Med. 2020 Aug;26(8):1218-1223. doi: 10.1038/s41591-020-0979-0. Epub 2020 Jun 24.
As of 10 April 2020, New York State had 180,458 cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and 9,385 reported deaths. Patients with cancer comprised 8.4% of deceased individuals. Population-based studies from China and Italy suggested a higher coronavirus disease 2019 (COVID-19) death rate in patients with cancer, although there is a knowledge gap as to which aspects of cancer and its treatment confer risk of severe COVID-19. This information is critical to balance the competing safety considerations of reducing SARS-CoV-2 exposure and cancer treatment continuation. From 10 March to 7 April 2020, 423 cases of symptomatic COVID-19 were diagnosed at Memorial Sloan Kettering Cancer Center (from a total of 2,035 patients with cancer tested). Of these, 40% were hospitalized for COVID-19, 20% developed severe respiratory illness (including 9% who required mechanical ventilation) and 12% died within 30 d. Age older than 65 years and treatment with immune checkpoint inhibitors (ICIs) were predictors for hospitalization and severe disease, whereas receipt of chemotherapy and major surgery were not. Overall, COVID-19 in patients with cancer is marked by substantial rates of hospitalization and severe outcomes. The association observed between ICI and COVID-19 outcomes in our study will need further interrogation in tumor-specific cohorts.
截至 2020 年 4 月 10 日，纽约州有 180458 例严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）病例和 9385 例报告死亡。癌症患者占死亡人数的 8.4%。来自中国和意大利的基于人群的研究表明，癌症患者的 2019 年冠状病毒病（COVID-19）死亡率较高，尽管对于癌症及其治疗的哪些方面会导致 COVID-19 重症的风险，还存在知识差距。这些信息对于平衡减少 SARS-CoV-2 暴露和癌症治疗继续的安全考虑因素至关重要。从 2020 年 3 月 10 日至 4 月 7 日，纪念斯隆凯特琳癌症中心（对 2035 例癌症患者进行了总计检测）诊断出 423 例有症状的 COVID-19 病例。其中，40%的患者因 COVID-19 住院，20%的患者出现严重呼吸道疾病（包括 9%需要机械通气），12%的患者在 30 天内死亡。年龄大于 65 岁和接受免疫检查点抑制剂（ICI）治疗是住院和重症的预测因素，而接受化疗和大手术则不是。总的来说，癌症患者的 COVID-19 具有很高的住院和严重结局的发生率。在我们的研究中观察到的 ICI 与 COVID-19 结局之间的关联需要在肿瘤特异性队列中进一步研究。
