Group of Epidemiology and Statistics on Cancer, AC Camargo Cancer Center, São Paulo, SP, Brazil.
Department of Infection Prevention and Control, AC Camargo Cancer Center, São Paulo, SP, Brazil.
Semin Oncol. 2021 Apr;48(2):171-180. doi: 10.1053/j.seminoncol.2021.01.003. Epub 2021 Feb 1.
To analyze COVID-19 mortality in cancer patients and associated factors such as age, sex, type of insurance, situation at COVID-19 diagnosis, and cancer histology during the pandemic at a cancer center in Brazil.
Cross-sectional study carried out from April 02, 2020 to August 31, 2020 at A.C. Camargo Cancer Center (ACCCC), in São Paulo, Brazil. Cases were extracted from the Hospital Cancer Registry. COVID-19 lethality rates by histology were calculated; multiple logistic regression was used to identify factors associated with COVID-19 mortality. The log-rank test was applied to compare the survival curves for each variable.
Of the 411 patients analyzed, 51 (12.4%) died due to COVID-19. Death occurred at an average age of 63 years. The fatality rate was higher for lung (0.333) and hematological (0.213) cancers and was associated with age over 60 years. The greatest chances of death from COVID-19 were in cases of lung (odds ratio, OR, 4.05, 95% confidence interval, CI 1.33-12.34) and hematological (OR 2.17, 95% CI 0.96-4.90) cancers, and in patients currently undergoing cancer treatment (OR 2.77, 95% CI 1.25-6.13). There were no statistical differences in survival by sex, age group, type of insurance, situation at the diagnosis of COVID-19, and histology of cancer for COVID-19.
Mortality due to COVID-19 in cancer patients is heterogeneous. These findings reinforce the need for individualized strategies for the management of different types of cancer that reduce the risk of death from COVID-19.
本研究旨在分析巴西某癌症中心在新冠疫情期间癌症患者的 COVID-19 死亡率及其相关因素，包括年龄、性别、保险类型、COVID-19 诊断时的情况和癌症组织学。
这是一项 2020 年 4 月 2 日至 8 月 31 日在巴西圣保罗 A.C.Camargo 癌症中心进行的横断面研究。病例从医院癌症登记处提取。计算了不同组织学类型 COVID-19 的病死率；采用多因素逻辑回归分析确定与 COVID-19 死亡相关的因素。应用对数秩检验比较每个变量的生存曲线。
在分析的 411 例患者中，有 51 例（12.4%）因 COVID-19 死亡。死亡平均年龄为 63 岁。肺癌（0.333）和血液癌（0.213）的病死率较高，且与 60 岁以上年龄相关。COVID-19 死亡的最大风险出现在肺癌（比值比，OR，4.05，95%置信区间，CI 1.33-12.34）和血液癌（OR 2.17，95%CI 0.96-4.90）病例，以及正在接受癌症治疗的患者中（OR 2.77，95%CI 1.25-6.13）。COVID-19 患者的性别、年龄组、保险类型、COVID-19 诊断时的情况和癌症组织学与生存率之间无统计学差异。
癌症患者因 COVID-19 导致的死亡率存在异质性。这些发现强调了需要制定个体化策略来管理不同类型的癌症，以降低 COVID-19 死亡的风险。
