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洛杉矶县医疗中心治疗的癌症患者中 COVID-19 感染的影响。

Impact of COVID-19 infection among cancer patients treated at the Los Angeles County Medical Center.

机构信息

Department of Medicine, Keck School of Medicine at the University of Southern California, Los Angeles; Los Angeles County + University of Southern California Medical Center, Los Angeles.

St. George's University School of Medicine.

出版信息

Cancer Treat Res Commun. 2021;26:100273. doi: 10.1016/j.ctarc.2020.100273. Epub 2020 Dec 10.

Abstract

We conducted a retrospective analysis of cancer patients who presented to the hospital with COVID-19 infection at a safety-net hospital in Los Angeles, California, from March 2020 to June 2020. From a list of 1,163 COVID-19+ adult patients, we selected the first 50 patients with malignancy for a preliminary analysis. There were 23 males (46.0%) and 27 females (54.0%); the median age was 60.5 years (IQR 47 - 72). Thirty-nine (78.0%) of the patients were Hispanic. The most prevalent cancers were genitourinary (14, 28.0%), hematologic (11, 22.0%), and gastrointestinal (10, 20.0%). Twenty-one (42.0%) patients had active disease at COVID-19 diagnosis, while 25 (50.0%) had no evidence of disease (NED), and 4 (8.0%) were unknown. Over 1 in 3 admitted patients experienced a "severe outcome," which was defined as critical level care (14, 34.1%), use of vasopressors (9, 22.0%), intubation (8, 19.5%), or death (5, 12.2%). Patients with severe outcomes were found to have statistically higher values of absolute neutrophil count (p = 0.005), aspartate aminotransferase (p = 0.049), high-sensitivity C-reactive protein, (p = 0.001) and lactate dehydrogenase (p = 0.040) on admission. Overall survival (OS) was not statistically different between those with hematologic versus solid malignancy nor between those with active disease versus remission (both p>0.05). Thirteen (81.3%) of the 16 patients who had cancer treatment in 2020 experienced delays in cancer therapy. Additional cases are being evaluated as the pandemic continues with the goal of identifying areas for potential intervention to improve outcomes in this at-risk population.

摘要

我们对 2020 年 3 月至 6 月期间在加利福尼亚州洛杉矶的一家安全网医院因 COVID-19 感染而住院的癌症患者进行了回顾性分析。在一份有 1163 例 COVID-19+成年患者的名单中,我们选择了前 50 例恶性肿瘤患者进行初步分析。其中男性 23 例(46.0%),女性 27 例(54.0%);中位年龄为 60.5 岁(IQR 47-72)。39 例(78.0%)患者为西班牙裔。最常见的癌症是泌尿生殖系统(14 例,28.0%)、血液系统(11 例,22.0%)和胃肠道(10 例,20.0%)。21 例(42.0%)患者在 COVID-19 诊断时患有活动性疾病,而 25 例(50.0%)无疾病证据(NED),4 例(8.0%)情况未知。超过 1/3 的入院患者经历了“严重结局”,这被定义为关键级别的护理(14 例,34.1%)、使用血管加压素(9 例,22.0%)、插管(8 例,19.5%)或死亡(5 例,12.2%)。研究发现,有严重结局的患者入院时的绝对中性粒细胞计数(p=0.005)、天门冬氨酸氨基转移酶(p=0.049)、高敏 C 反应蛋白(p=0.001)和乳酸脱氢酶(p=0.040)值更高。血液系统恶性肿瘤与实体恶性肿瘤之间以及活动性疾病与缓解期之间的总生存率(OS)无统计学差异(均 p>0.05)。2020 年接受癌症治疗的 16 例患者中有 13 例(81.3%)癌症治疗延迟。随着大流行的继续,正在评估更多病例,目的是确定潜在干预领域,以改善这一高危人群的结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc8e/7728418/20cfe89d0684/gr1_lrg.jpg

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