Cherri Sara, Lemmers Daniel H L, Noventa Silvia, Abu Hilal Mohammed, Zaniboni Alberto
Department of Clinical Oncology, Fondazione Poliambulanza, Brescia, Italy.
Department of Surgery, Fondazione Poliambulanza, Brescia, Italy.
Ther Adv Med Oncol. 2020 Sep 30;12:1758835920962370. doi: 10.1177/1758835920962370. eCollection 2020.
Recent literature regarding the outcome of cancer patients infected with COVID-19 are not encouraging. Nevertheless, current evidence on the risk and benefits of continuing oncological treatment of cancer patients during the pandemic remains insufficient. We provide our experience in a center with high access for patients with COVID-19-associated pneumonia in Lombardy, Italy. We conducted a retrospective study using a prospectively maintained database of patients admitted to our hospital between 25 February 2020 and 9 April 2020 with a confirmed diagnosis of COVID-19 pneumonia.
A total of 53 patients with a history or current oncological disease were included in this study. Sixteen oncological patients (30.2%) died during hospitalization. Multivariable logistic regression analysis found that age (Odds ratio [OR]: 1.17, = 0.009), diabetes (OR: 15.05, = 0.028) and active oncological disease (OR 13.60, = 0.015) were independently associated with in-hospital mortality. The mortality rate of the total number of cancer patients is about twice as high as that of non-oncological patients admitted to our hospital with a diagnosis of COVID-19.
The presence of active oncological disease is independently related to mortality as well as age and diabetes. The majority of patients who died were frail. Careful evaluation of the risks and benefits of treatment in frail patients is needed, considering that difficult access to intensive care may have affected the mortality rate.
近期有关感染新型冠状病毒肺炎(COVID-19)的癌症患者预后的文献结果并不乐观。然而,目前关于在疫情期间继续对癌症患者进行肿瘤治疗的风险和益处的证据仍然不足。我们介绍了在意大利伦巴第大区一家为COVID-19相关性肺炎患者提供高就诊率的中心的经验。我们进行了一项回顾性研究,使用了一个前瞻性维护的数据库,该数据库包含2020年2月25日至2020年4月9日期间我院收治的确诊为COVID-19肺炎的患者。
本研究共纳入53例有既往或当前肿瘤疾病史的患者。16例肿瘤患者(30.2%)在住院期间死亡。多变量逻辑回归分析发现,年龄(比值比[OR]:1.17,P = 0.009)、糖尿病(OR:15.05,P = 0.028)和活动性肿瘤疾病(OR 13.60,P = 0.015)与住院死亡率独立相关。癌症患者总数的死亡率约是非肿瘤患者(我院诊断为COVID-19入院)的两倍。
活动性肿瘤疾病的存在与死亡率以及年龄和糖尿病独立相关。大多数死亡患者身体虚弱。考虑到重症监护难以获得可能影响死亡率,需要对身体虚弱患者治疗的风险和益处进行仔细评估。