Department of Medical Oncology, Institut Curie, Paris & Saint Cloud, France.
Department of Radiology, Institut Curie, Paris, France.
JNCI Cancer Spectr. 2021 Jan 6;5(1):pkaa090. doi: 10.1093/jncics/pkaa090. eCollection 2021 Feb.
Concerns have emerged about the higher risk of fatal coronavirus disease 2019 (COVID-19) in cancer patients. In this article, we review the experience of a comprehensive cancer center.
A prospective registry was set up at Institut Curie at the beginning of the COVID-19 pandemic. All cancer patients with suspected or proven COVID-19 were entered and actively followed for 28 days.
Among 9842 patients treated at Institut Curie between March 13 and May 1, 2020, 141 (1.4%) were diagnosed with COVID-19, based on reverse transcription polymerase chain reaction testing and/or computerized tomography scan. In line with our case mix, breast cancer (40.4%) was the most common tumor type, followed by hematological and lung malignancies. Patients with active cancer therapy or/and advanced cancer accounted for 87.9% and 68.9% of patients, respectively. At diagnosis, 78.7% of patients had COVID-19-related symptoms, with an extent of lung parenchyma involvement inferior to 50% in 95.8% of patients. Blood count variations and C-reactive protein elevation were the most common laboratory abnormalities. Antibiotics and antiviral agents were administered in 48.2% and 6.4% of patients, respectively. At the time of analysis, 26 patients (18.4%) have died from COVID-19, and 100 (70.9%) were cured. Independent prognostic factors at the time of COVID-19 diagnosis associated with death or intensive care unit admission were extent of COVID-19 pneumonia and decreased O saturation.
COVID-19 incidence and presentation in cancer patients appear to be very similar to those in the general population. The outcome of COVID-19 is primarily driven by the initial severity of infection rather than patient or cancer characteristics.
人们对癌症患者感染 2019 年冠状病毒病(COVID-19)的致死风险较高表示担忧。在本文中,我们回顾了一家综合性癌症中心的经验。
在 COVID-19 大流行开始时,居里研究所设立了一个前瞻性登记处。所有疑似或确诊 COVID-19 的癌症患者均被纳入并积极随访 28 天。
在 2020 年 3 月 13 日至 5 月 1 日期间,居里研究所治疗的 9842 名患者中,根据逆转录聚合酶链反应检测和/或计算机断层扫描,有 141 名(1.4%)被诊断为 COVID-19。与我们的病例组合一致,乳腺癌(40.4%)是最常见的肿瘤类型,其次是血液系统和肺部恶性肿瘤。分别有 87.9%和 68.9%的患者正在接受癌症治疗或/和晚期癌症治疗。在诊断时,78.7%的患者有 COVID-19 相关症状,95.8%的患者肺部实质受累程度低于 50%。血常规变化和 C 反应蛋白升高是最常见的实验室异常。分别有 48.2%和 6.4%的患者接受了抗生素和抗病毒药物治疗。在分析时,26 名患者(18.4%)死于 COVID-19,100 名患者(70.9%)治愈。COVID-19 诊断时与死亡或入住重症监护病房相关的独立预后因素是 COVID-19 肺炎的严重程度和氧饱和度降低。
癌症患者 COVID-19 的发病率和表现与一般人群非常相似。COVID-19 的结局主要由感染的初始严重程度决定,而不是患者或癌症特征。