Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Department of Pulmonary Diseases, Erasmus MC, Rotterdam, the Netherlands.
Eur J Cancer. 2020 Dec;141:171-184. doi: 10.1016/j.ejca.2020.09.027. Epub 2020 Oct 7.
Patients with cancer might have an increased risk for severe outcome of coronavirus disease 2019 (COVID-19). To identify risk factors associated with a worse outcome of COVID-19, a nationwide registry was developed for patients with cancer and COVID-19.
This observational cohort study has been designed as a quality of care registry and is executed by the Dutch Oncology COVID-19 Consortium (DOCC), a nationwide collaboration of oncology physicians in the Netherlands. A questionnaire has been developed to collect pseudonymised patient data on patients' characteristics, cancer diagnosis and treatment. All patients with COVID-19 and a cancer diagnosis or treatment in the past 5 years are eligible.
Between March 27th and May 4th, 442 patients were registered. For this first analysis, 351 patients were included of whom 114 patients died. In multivariable analyses, age ≥65 years (p < 0.001), male gender (p = 0.035), prior or other malignancy (p = 0.045) and active diagnosis of haematological malignancy (p = 0.046) or lung cancer (p = 0.003) were independent risk factors for a fatal outcome of COVID-19. In a subgroup analysis of patients with active malignancy, the risk for a fatal outcome was mainly determined by tumour type (haematological malignancy or lung cancer) and age (≥65 years).
The findings in this registry indicate that patients with a haematological malignancy or lung cancer have an increased risk of a worse outcome of COVID-19. During the ongoing COVID-19 pandemic, these vulnerable patients should avoid exposure to severe acute respiratory syndrome coronavirus 2, whereas treatment adjustments and prioritising vaccination, when available, should also be considered.
癌症患者罹患 2019 冠状病毒病(COVID-19)重症的风险可能增加。为明确与 COVID-19 不良结局相关的危险因素,我们为癌症合并 COVID-19 患者建立了全国性登记处。
本观察性队列研究设计为质量关怀登记处,由荷兰肿瘤 COVID-19 联盟(DOCC)执行,该联盟是荷兰肿瘤医生的全国性合作组织。开发了一份问卷,以收集患者特征、癌症诊断和治疗的匿名患者数据。所有患有 COVID-19 且在过去 5 年内有癌症诊断或治疗的患者均符合入组条件。
在 3 月 27 日至 5 月 4 日期间,共登记了 442 例患者。在本次首次分析中,共纳入 351 例患者,其中 114 例死亡。多变量分析显示,年龄≥65 岁(p<0.001)、男性(p=0.035)、既往或其他恶性肿瘤(p=0.045)、正在诊断的血液恶性肿瘤(p=0.046)或肺癌(p=0.003)是 COVID-19 致死结局的独立危险因素。在正在接受恶性肿瘤治疗的患者亚组分析中,致死结局的风险主要取决于肿瘤类型(血液恶性肿瘤或肺癌)和年龄(≥65 岁)。
该登记处的结果表明,患有血液恶性肿瘤或肺癌的患者 COVID-19 不良结局的风险增加。在当前 COVID-19 大流行期间,这些脆弱患者应避免接触严重急性呼吸综合征冠状病毒 2,同时还应考虑调整治疗方案和优先接种疫苗(如有)。