Di Cosimo Serena, Tagliaferri Barbara, Generali Daniele, Giudici Fabiola, Agustoni Francesco, Bernardo Antonio, Borgonovo Karen, Farina Gabriella, Luchena Giovanna, Luciani Andrea, Nolè Franco, Palmeri Laura, Pietrantonio Filippo, Poggi Guido, Zucali Paolo Andrea, Balletti Emanuela, Catania Giovanna, Bernocchi Ottavia, D'Antonio Federica, Giordano Monica, Grossi Francesco, Lasagna Angioletta, La Verde Nicla, Manzoni Mariangela, Montagna Benedetta, Olgiati Angelo, Raimondi Alessandra, Rampinelli Irene, Verri Elena, Zaniboni Alberto, Di Maio Massimo, Beretta Giordano, Danova Marco
Department of Applied Research and Technological Development, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milano, Italy.
Medical Oncology Unit, ICS Maugeri-IRCCS, 27100 Pavia, Italy.
Cancers (Basel). 2021 Mar 16;13(6):1324. doi: 10.3390/cancers13061324.
Cancer patients may be at high risk of infection and poor outcomes related to SARS-CoV-2. Analyzing their prognosis, examining the effects of baseline characteristics and systemic anti-cancer active therapy (SACT) are critical to their management through the evolving COVID-19 pandemic. The AIOM-L CORONA was a multicenter, observational, ambispective, cohort study, with the intended participation of 26 centers in the Lombardy region (Italy). A total of 231 ases were included between March and September 2020. The median age was 68 years; 151 patients (62.2%) were receiving SACT, mostly chemotherapy. During a median follow-up of 138 days (range 12-218), 93 events occurred. Age ≥60 years, metastatic dissemination, dyspnea, desaturation, and interstitial pneumonia were all independent mortality predictors. Overall SACT had a neutral effect (Odds Ratio [OR] 0.83, 95%Confidence Interval [95%CI] 0.32-2.15); however, metastatic patients receiving SACT were less likely to die as compared to untreated counterparts, after adjusting for other confounding variables (OR 0.23, 95%CI 0.11-0.51, < 0.001). Among cancer patients infected by SARS-CoV-2, those with metastases were most at risk of death, especially in the absence of SACT. During the ongoing pandemic, these vulnerable patients should avoid exposure to SARS-CoV-2, while treatment adjustments and prioritizing vaccination are being considered according to international recommendations.
癌症患者可能面临与SARS-CoV-2相关的高感染风险和不良预后。分析他们的预后、检查基线特征和全身抗癌活性治疗(SACT)的效果对于在不断演变的COVID-19大流行期间对他们的管理至关重要。AIOM-L CORONA是一项多中心、观察性、双向队列研究,计划有意大利伦巴第地区的26个中心参与。2020年3月至9月期间共纳入231例病例。中位年龄为68岁;151例患者(62.2%)正在接受SACT,主要是化疗。在中位随访138天(范围12 - 218天)期间,发生了93起事件。年龄≥60岁、转移扩散、呼吸困难、血氧饱和度降低和间质性肺炎都是独立的死亡预测因素。总体SACT有中性作用(优势比[OR] 0.83,95%置信区间[95%CI] 0.32 - 2.15);然而,在调整其他混杂变量后,接受SACT的转移患者与未接受治疗的患者相比死亡可能性较小(OR 0.