Zhang Bo, Yu Yuanhang, Hubert Shawna M, Zhang Yue, Lu Jianhua, Liu Shihua, Xie Fang, Zhao Liang, Lei Xiao, Deng Wei, Chen Jianying, Li Yunqiao
Department of Thyroid and Breast Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Thoracic Medical Oncology, Department of Genomic Medicine, The University of Texas, MD Anderson Cancer Center, Houston, TX, United States.
Front Pharmacol. 2020 Oct 22;11:576994. doi: 10.3389/fphar.2020.576994. eCollection 2020.
At present, the epidemic of the novel coronavirus disease 2019 (COVID-19) has quickly engulfed the world. Inflammatory cytokines are associated with the severity and outcomes of patients with COVID-19. However, the prognostic value of pro-inflammatory factors in cancer patients with COVID-19 are unknown. A multi-center, retrospective, cross-sectional study, based on five designated tertiary hospitals for the treatment of COVID-19 in Hubei Province, China. 112 cancer patients with COVID-19, and 105 COVID-19 patients without cancer were enrolled in the study between January 1st, 2020 and April 30th, 2020. The risk assessment of pro-inflammatory factors for disease severity and clinical adverse outcomes was identified by univariable and multivariable logistic regression models. Of the 112 cancer patients with COVID-19, 40 (35.7%) patients were in critical condition and 18 (16.1%) patients died unfortunately. Univariate and multivariate analysis demonstrated that hemoglobin level and pro-inflammatory neutrophils and C-reactive protein (CRP), can be used as independent factors affecting the severity of COVID-19; Meanwhile, pro-inflammatory neutrophils and CRP can be used as an independent influencing factor for adverse clinical outcome of death. Moreover, the dynamic changes of neutrophils and CRP were also presented, and compared with COVID-19 patients without cancer, cancer patients with COVID-19 showed higher neutrophil counts and CRP levels. In cancer patients with COVID-19, the significant increase in pro-inflammatory neutrophils and CRP indicated a more critical illness and adverse clinical outcome, and pro-inflammatory neutrophils and CRP played a greater adverse role compare with COVID-19 patients without cancer, which may be the cause of critical illness and adverse clinical outcomes of cancer patients with COVID-19.
目前,2019年新型冠状病毒病(COVID-19)疫情迅速席卷全球。炎性细胞因子与COVID-19患者的病情严重程度及预后相关。然而,促炎因子在合并COVID-19的癌症患者中的预后价值尚不清楚。本研究是一项多中心、回顾性横断面研究,基于中国湖北省五家指定的COVID-19治疗三级医院开展。2020年1月1日至2020年4月30日期间,研究纳入了112例合并COVID-19的癌症患者以及105例未患癌症的COVID-19患者。通过单变量和多变量逻辑回归模型确定促炎因子对疾病严重程度和临床不良结局的风险评估。在112例合并COVID-19的癌症患者中,40例(35.7%)病情危重,18例(16.1%)不幸死亡。单因素和多因素分析表明,血红蛋白水平、促炎中性粒细胞及C反应蛋白(CRP)可作为影响COVID-19严重程度的独立因素;同时,促炎中性粒细胞和CRP可作为死亡这一不良临床结局的独立影响因素。此外,还呈现了中性粒细胞和CRP的动态变化,与未患癌症的COVID-19患者相比,合并COVID-19的癌症患者中性粒细胞计数和CRP水平更高。在合并COVID-19的癌症患者中,促炎中性粒细胞和CRP的显著升高表明病情更危重及临床结局不良,与未患癌症的COVID-19患者相比,促炎中性粒细胞和CRP发挥了更大的不良作用,这可能是合并COVID-19的癌症患者病情危重及临床结局不良的原因。