Department of Medicine I, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
German Cancer Consortium (DKTK), Partner Site Freiburg, Freiburg, Germany.
Cancer Med. 2020 Nov;9(22):8412-8422. doi: 10.1002/cam4.3460. Epub 2020 Sep 15.
Patients with cancer are considered a high-risk group for viral pneumonia, with an increased probability of fatal outcome. Here, we investigated the clinical characteristics and outcome of patients with solid and hematological cancers and concomitant Covid-19 at a Comprehensive Cancer Center in a Covid-19 hotspot area in Germany.
We performed a retrospective single center cohort study of 39 patients with hematological and solid cancers who were hospitalized at the University Hospital Freiburg for Covid-19. Using univariate and multivariate Cox regression models we compared time to severe events and overall survival to an age-matched control cohort of 39 patients with confirmed Covid-19 without a cancer diagnosis.
In the cancer cohort 29 patients had a diagnosis of a solid tumor, and 10 had a hematological malignancy. In total, eight patients (21%) in the cancer and 14 patients (36%) from the noncancer cohort died during the observation period. Presence of a malignancy was not significantly associated with survival or time to occurrence of severe events. Major influences on mortality were high IL-6 levels at Covid-19 diagnosis (HR = 6.95, P = .0121) and age ≥ 65 years (HR = 6.22, P = .0156).
Compared to an age-matched noncancer cohort, we did not observe an association between a cancer diagnosis and a more severe disease course or higher fatality rate in patients with Covid-19. Patients with a hematological malignancy showed a trend towards a longer duration until clinical improvement and longer hospitalization time compared to patients with a solid cancer. Cancer per se does not seem to be a confounder for dismal outcome in Covid-19.
癌症患者被认为是病毒性肺炎的高危人群，其致死结局的概率增加。在这里，我们研究了在德国新冠病毒热点地区的一家综合性癌症中心患有实体瘤和血液系统恶性肿瘤并合并新冠病毒感染的患者的临床特征和结局。
我们对在弗莱堡大学医院因新冠病毒感染住院的 39 名血液系统和实体瘤癌症患者进行了回顾性单中心队列研究。使用单变量和多变量 Cox 回归模型，我们将时间到严重事件和总生存与年龄匹配的 39 名无癌症诊断的确诊新冠病毒感染但无癌症患者的对照队列进行了比较。
癌症队列中 29 名患者患有实体瘤，10 名患者患有血液系统恶性肿瘤。在癌症队列中共有 8 名患者（21%）和非癌症队列中 14 名患者（36%）在观察期间死亡。恶性肿瘤的存在与生存或发生严重事件的时间无显著相关性。死亡率的主要影响因素为新冠病毒感染时高白细胞介素-6 水平（HR=6.95，P=.0121）和年龄≥65 岁（HR=6.22，P=.0156）。
与年龄匹配的非癌症队列相比，我们没有观察到癌症诊断与新冠病毒感染患者更严重的疾病过程或更高的死亡率之间存在关联。与实体瘤患者相比，血液系统恶性肿瘤患者的临床改善时间更长，住院时间更长，呈趋势性差异。癌症本身似乎不是新冠病毒感染不良结局的混杂因素。
