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实体瘤癌症患者感染 SARS-CoV-2 的严重程度和 1 个月预后:一项丹麦全国队列研究。

Severity and 1-month outcome of SARS-CoV-2 infection in patients with solid cancers: a Danish nationwide cohort study.

机构信息

Department of Oncology, Odense University Hospital, Denmark.

Department of Clinical Research, University of Southern Denmark, Denmark.

出版信息

Acta Oncol. 2021 Jul;60(7):859-865. doi: 10.1080/0284186X.2021.1889659. Epub 2021 Mar 1.

Abstract

BACKGROUND

Cancer patients are vulnerable to infections, are older and often have comorbidities in comparison to the general population, which increases the risk for severe outcomes related to COVID-19 diagnosis.

METHODS

This study is a prospective, nationwide study in patients with solid cancer and SARS-CoV-2 infection included between 10 March to 15 June 2020. Patient's baseline characteristics were collected. The study's primary outcome was overall survival within 30 days of verified SARS-CoV-2 infection. Secondary outcomes were hospital admission, admission to an ICU, and need for supplemental oxygen.

RESULTS

A total of 112 patients with a cancer diagnosis and verified SARS-CoV-2 infection were identified. After one month of follow up, hospitalization was required for 54% ( = 61) and 21% of the patients had died and 14 of the 23 deceased cancer patients were ≥70 years. Most patients were classified with mild COVID-19 symptoms (66%,  = 74); however, 48% ( = 23) of the ≥70-year-olds patients were classified with severe or critical COVID-19 symptoms. Among the total study population, 61% ( = 68) had comorbidities and comorbidity were more frequently observed among the deceased (91%,  = 21) and older cancer patients (≥70 years, 81%,  = 39).

CONCLUSIONS

Acknowledging the low sample size in this study, our work shows that age and comorbidities, but not recent cytotoxic therapy, are associated with adverse outcomes of SARS-CoV-2 infection for patients with solid cancer. Particularly, patients with progressive disease seem to be at greater risk of a fatal outcome from COVID-19.HighlightsAge, performance status, and comorbidities are strong predictors of adverse outcome in cancer patients with SARS-CoV-2 infection.Patients with progressive cancer disease seem to be at greater risk of a fatal outcome from COVID-19.Recent cytotoxic therapy, however, did not seem to be associated with increased risk for adverse outcomes of SARS-CoV-2 infection for patients with solid cancer.

摘要

背景

与普通人群相比,癌症患者更容易感染,年龄更大且常合并症,这增加了与 COVID-19 诊断相关的严重后果的风险。

方法

本研究是一项针对 2020 年 3 月 10 日至 6 月 15 日期间确诊患有实体瘤和 SARS-CoV-2 感染的患者的前瞻性全国性研究。收集患者的基线特征。主要研究终点是 SARS-CoV-2 感染确诊后 30 天内的总生存率。次要终点是住院,入住 ICU 和需要补充氧气。

结果

共确定了 112 例患有癌症诊断和确诊 SARS-CoV-2 感染的患者。在一个月的随访后,需要住院的患者有 54%(61 例),21%的患者死亡,23 名死亡的癌症患者中有 14 名年龄≥70 岁。大多数患者被归类为 COVID-19 轻症(66%,74 例);但是,48%(23 例)年龄≥70 岁的患者被归类为重症或危重症 COVID-19。在总研究人群中,61%(68 例)患有合并症,并且死亡患者(91%,21 例)和年龄较大的癌症患者(年龄≥70 岁,81%,39 例)中更频繁地观察到合并症。

结论

尽管本研究的样本量较小,但我们的工作表明,年龄和合并症,而不是最近的细胞毒性治疗,与实体瘤癌症患者 SARS-CoV-2 感染的不良结局相关。特别是,进展性疾病的患者似乎有更大的风险死于 COVID-19。

重点

年龄、表现状态和合并症是 SARS-CoV-2 感染癌症患者不良结局的重要预测指标。患有进展性癌症疾病的患者似乎有更大的风险死于 COVID-19。然而,最近的细胞毒性治疗似乎并未增加实体瘤癌症患者 SARS-CoV-2 感染不良结局的风险。

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