Fuentes-Antrás Jesús, Manzano Aránzazu, Marquina Gloria, Paz Mateo, Aguado Carlos, Granja Mónica, Benítez Javier, Ortega Justo, Priego Araceli, González Carlos, Tejerina-Peces Julia, Flores Paloma, de Sa Alfonso López, Toledano Carmen, Olalla Jennifer, de Luna Alicia, Bartolomé Jorge, Pérez-Segura Pedro
Medical Oncology Department, Clínico San Carlos University Hospital, Madrid, Spain.
Experimental Therapeutics and Translational Oncology Unit. Medical Oncology Department, Clínico San Carlos University Hospital, Madrid, Spain.
Int J Cancer. 2021 May 15;148(10):2389-2397. doi: 10.1002/ijc.33420. Epub 2020 Dec 19.
Coronavirus disease 2019 (COVID-19) pandemic is affecting a high percentage of the population at an unprecedented rate. Cancer patients comprise a subgroup especially vulnerable to this infection. Herein, we present a prospective analysis of epidemiological, clinical, radiological and laboratory data of consecutive adult cancer patients seen in the Clínico San Carlos University Hospital (Madrid, Spain), and admitted to hospital and tested for COVID-19 between 21 February 2020 and 8 May 2020 due to clinical suspicion of infection. Data from 73 patients with confirmed COVID-19 and active solid tumors or diagnosed within the previous 5 years were analyzed. The most frequent malignancy was lung cancer (19%) and 54 patients (74%) were on active cancer treatment. Most common findings on presentation included cough (55%), fever (52%) and dyspnea (45%), and 32 (44%) patients showed oxygen saturation levels below 95%. Radiologically, 54 (73%) patients presented an abnormal pattern, the most frequent being infiltrates (64%). 18 (24.7%) patients died in hospital and 55 (75.3%) were discharged with clinical resolution of the event. Multivariable logistic regression adjusted for age and tumor stage showed higher odds of in-hospital death associated with a history of cardiovascular disease, hospitalization in the previous 30 days, and several features on admission including dyspnea, higher qSOFA score, higher C-reactive protein levels and an abnormal neutrophil count. We present prospective, real-world evidence that can help articulate cancer care protocols for patients infected with SARS-CoV-2, with special focus on features on admission that can stratify patients with a higher risk of death from COVID-19.
2019冠状病毒病(COVID-19)大流行正以前所未有的速度影响着很大比例的人口。癌症患者是特别容易感染这种疾病的一个亚组。在此,我们对西班牙马德里圣卡洛斯大学医院收治的、因临床怀疑感染于2020年2月21日至2020年5月8日期间入院并接受COVID-19检测的成年癌症患者的流行病学、临床、放射学和实验室数据进行了前瞻性分析。分析了73例确诊COVID-19且患有活动性实体瘤或在过去5年内确诊的患者的数据。最常见的恶性肿瘤是肺癌(19%),54例(74%)患者正在接受积极的癌症治疗。就诊时最常见的表现包括咳嗽(55%)、发热(52%)和呼吸困难(45%),32例(44%)患者的血氧饱和度水平低于95%。放射学检查方面,54例(73%)患者表现出异常模式,最常见的是浸润(64%)。18例(24.7%)患者在医院死亡,55例(75.3%)患者临床症状缓解后出院。经年龄和肿瘤分期调整的多变量逻辑回归分析显示,心血管疾病史、过去30天内住院以及入院时的一些特征(包括呼吸困难、较高的qSOFA评分、较高的C反应蛋白水平和异常的中性粒细胞计数)与院内死亡几率较高相关。我们提供了前瞻性的真实世界证据,有助于明确针对感染SARS-CoV-2患者的癌症护理方案,特别关注入院时可将COVID-19死亡风险较高的患者进行分层的特征。