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与实体瘤或血液系统恶性肿瘤患者 SARS-CoV-2 感染和结局相关的因素:一项单中心研究。

Factors associated with SARS-CoV-2 infection and outcome in patients with solid tumors or hematological malignancies: a single-center study.

机构信息

Internal Medicine, Institut Jules Bordet, rue Heger 1, 1000, Brussels, Belgium.

Clinical Trials Conduct Unit, Institut Jules Bordet, rue Heger 1, 1000, Brussels, Belgium.

出版信息

Support Care Cancer. 2021 Nov;29(11):6271-6278. doi: 10.1007/s00520-021-06175-z. Epub 2021 Apr 14.

Abstract

BACKGROUND

Immunocompromised cancer patients are presumed to be at high risk of developing COVID-19 infection. Predisposing factors to contracting COVID-19 and to severe outcomes have been described in registries but were not compared between solid tumors and hematological malignancies.

METHOD

This retrospective single oncologic center study included adults with solid tumors or hematological malignancies referred to testing by naso-pharyngeal swab for a SARS-CoV-2 RT-PCR from March 10 to May 18, 2020.

RESULTS

A total of 212 patients were included in the study. Forty-five (21%) were tested positive with SARS-CoV-2. The univariate analysis with positive SARS-CoV-2 PCR as a dependent variable reveals significant odds ratios (ORs) for age-with a mean of 62.5 years-(OR: 1.05, 95% CI: 1.02-1.08), performance status ≥2 (OR: 2.38, 95% CI: 1.22-4.70), inpatient status (OR: 2.36, 95%CI: 1.11-4.91), and hematological malignancies (OR: 2.48, 95% CI: 1.23-4.96). In contrast, OR for solid tumors reveals a negative association (OR: 0.40, 95% CI: 0.20-0.81). When integrating severe outcome (ICU admission or COVID-19-related death) as a dependent variable, the univariate logistic regression model shows significant ORs for pre-existing lymphopenia (OR: 4.0, 95% CI: 1.17-15.04), hematological malignancies (OR: 3.73, 95% CI: 1.09-13.80), and a negative association for solid tumors (OR: 0.27; 95% CI: 0.07-0.92).

CONCLUSION

In patients referred for SARS-CoV-2 testing, hematological malignancies were associated with a higher risk of COVID-19 infection and severe outcomes. Other factors were age and inpatient status.

摘要

背景

免疫功能低下的癌症患者被认为感染 COVID-19 的风险较高。已在登记处描述了感染 COVID-19 和出现严重后果的易患因素,但尚未在实体瘤和血液恶性肿瘤之间进行比较。

方法

本回顾性单中心研究纳入了 2020 年 3 月 10 日至 5 月 18 日因 SARS-CoV-2 RT-PCR 检测而接受鼻咽拭子检测的实体瘤或血液恶性肿瘤成人患者。

结果

共有 212 例患者纳入研究。45 例(21%)检测出 SARS-CoV-2 阳性。将 SARS-CoV-2 PCR 阳性作为因变量的单因素分析显示,年龄(平均 62.5 岁)、体力状态≥2 分、住院状态和血液恶性肿瘤的比值比(OR)均有显著意义(OR:1.05,95%CI:1.02-1.08)、(OR:2.38,95%CI:1.22-4.70)、(OR:2.36,95%CI:1.11-4.91)和(OR:2.48,95%CI:1.23-4.96)。相比之下,实体瘤的 OR 显示为负相关(OR:0.40,95%CI:0.20-0.81)。当将严重结局(入住 ICU 或 COVID-19 相关死亡)作为因变量进行整合时,单因素逻辑回归模型显示,预先存在的淋巴细胞减少症(OR:4.0,95%CI:1.17-15.04)、血液恶性肿瘤(OR:3.73,95%CI:1.09-13.80)和实体瘤的负相关(OR:0.27;95%CI:0.07-0.92)有显著意义。

结论

在因 SARS-CoV-2 检测而被转诊的患者中,血液恶性肿瘤与 COVID-19 感染和严重结局的风险增加相关。其他因素为年龄和住院状态。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0891/8464574/57973b9e948b/520_2021_6175_Fig1_HTML.jpg

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