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荷兰肿瘤学 COVID-19 联合会:全国队列研究中癌症患者 COVID-19 的结局。

Dutch Oncology COVID-19 consortium: Outcome of COVID-19 in patients with cancer in a nationwide cohort study.

机构信息

Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.

Department of Pulmonary Diseases, Erasmus MC, Rotterdam, the Netherlands.

出版信息

Eur J Cancer. 2020 Dec;141:171-184. doi: 10.1016/j.ejca.2020.09.027. Epub 2020 Oct 7.

Abstract

AIM OF THE STUDY

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

研究目的

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。

方法

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。

结果

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)。

结论

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)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e071/7540213/701fab180b97/gr1_lrg.jpg

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