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COVID-19 感染癌症患者的临床特征和结局:系统评价和荟萃分析。

Clinical Characteristics and Outcomes of COVID-19-Infected Cancer Patients: A Systematic Review and Meta-Analysis.

机构信息

Laura and Isaac Perlmutter Cancer Center, New York University Langone Medical Center, New York, NY, USA.

Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.

出版信息

J Natl Cancer Inst. 2021 Apr 6;113(4):371-380. doi: 10.1093/jnci/djaa168.

Abstract

BACKGROUND

Previous studies have indicated coronavirus disease 2019 (COVID-19) patients with cancer have a high fatality rate.

METHODS

We conducted a systematic review of studies that reported fatalities in COVID-19 patients with cancer. A comprehensive meta-analysis that assessed the overall case fatality rate and associated risk factors was performed. Using individual patient data, univariate and multivariable logistic regression analyses were used to estimate odds ratios (OR) for each variable with outcomes.

RESULTS

We included 15 studies with 3019 patients, of which 1628 were men; 41.0% were from the United Kingdom and Europe, followed by the United States and Canada (35.7%), and Asia (China, 23.3%). The overall case fatality rate of COVID-19 patients with cancer measured 22.4% (95% confidence interval [CI] = 17.3% to 28.0%). Univariate analysis revealed age (OR = 3.57, 95% CI = 1.80 to 7.06), male sex (OR = 2.10, 95% CI = 1.07 to 4.13), and comorbidity (OR = 2.00, 95% CI = 1.04 to 3.85) were associated with increased risk of severe events (defined as the individuals being admitted to the intensive care unit, or requiring invasive ventilation, or death). In multivariable analysis, only age greater than 65 years (OR = 3.16, 95% CI = 1.45 to 6.88) and being male (OR = 2.29, 95% CI = 1.07 to 4.87) were associated with increased risk of severe events.

CONCLUSIONS

Our analysis demonstrated that COVID-19 patients with cancer have a higher fatality rate compared with that of COVID-19 patients without cancer. Age and sex appear to be risk factors associated with a poorer prognosis.

摘要

背景

先前的研究表明,患有癌症的 2019 年冠状病毒病(COVID-19)患者死亡率较高。

方法

我们对报道 COVID-19 合并癌症患者死亡的研究进行了系统回顾。进行了全面的荟萃分析,评估了总体病死率和相关危险因素。使用个体患者数据,进行单变量和多变量逻辑回归分析,以估计每个变量与结局相关的优势比(OR)。

结果

我们纳入了 15 项研究,共 3019 例患者,其中 1628 例为男性;41.0%来自英国和欧洲,其次是美国和加拿大(35.7%)以及亚洲(中国,23.3%)。COVID-19 合并癌症患者的总体病死率为 22.4%(95%置信区间[CI] = 17.3%至 28.0%)。单变量分析显示,年龄(OR = 3.57,95%CI = 1.80 至 7.06)、男性(OR = 2.10,95%CI = 1.07 至 4.13)和合并症(OR = 2.00,95%CI = 1.04 至 3.85)与严重事件(定义为患者入住重症监护病房、需要有创通气或死亡)的风险增加相关。多变量分析中,仅年龄大于 65 岁(OR = 3.16,95%CI = 1.45 至 6.88)和男性(OR = 2.29,95%CI = 1.07 至 4.87)与严重事件风险增加相关。

结论

我们的分析表明,COVID-19 合并癌症患者的死亡率高于 COVID-19 无癌症患者。年龄和性别似乎是与预后较差相关的危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/99d2/8023828/d6fe89d17c11/djaa168f1.jpg

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