Liu Chao, Wang Kai, Li Luyuan, Lv Qingquan, Liu Yumei, Hu Tian, Trent Jonathan C, Sun Bing, Hu Qinyong
Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, China.
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
J Cancer. 2021 Apr 24;12(12):3558-3565. doi: 10.7150/jca.54205. eCollection 2021.
Data are extremely limited with regards to the impact of COVID-19 on cancer patients. Our study explored the distinct clinical features of COVID-19 patients with cancer. 189 COVID-19 patients, including 16 cancer patients and 173 patients without cancer, were recruited. Propensity score 1:4 matching (PSM) was performed between cancer patients and patients without cancer based on age, gender and comorbidities. Survival was calculated by the Kaplan-Meier method and the difference was compared by the log-rank test. PSM analysis yielded 16 cancer patients and 64 propensity score-matched patients without cancer. Compared to patients without cancer, cancer patients tended to have leukopenia and elevated high-sensitivity C-reactive protein (hs-CRP) and procalcitonin. For those with critical COVID-19, cancer patients had an inferior survival than those without cancer. Also, cancer patients with severe/critical COVID-19 tended to be male and present with low SO and albumin, and high hs-CRP, lactate dehydrogenase and blood urea nitrogen on admission compared to those with mild COVID-19. In terms of risk factors, recent cancer diagnosis (within 1 year of onset of COVID-19) and anti-tumor treatment within 3 months of COVID-19 diagnosis were associated with inferior survival. We found COVID-19 patients with cancer have distinct clinical features as compared to patients without cancer. Importantly, cancer patients with critical COVID-19 were found to have poorer outcomes compared to those without cancer. In the cancer cohort, patients with severe/critical COVID-19 presented with a distinct clinical profile from those with mild COVID-19; short cancer history and recent anti-cancer treatment were associated with inferior survival.
关于新冠病毒病（COVID-19）对癌症患者的影响，数据极为有限。我们的研究探讨了合并癌症的COVID-19患者的独特临床特征。招募了189例COVID-19患者，其中包括16例癌症患者和173例非癌症患者。基于年龄、性别和合并症，对癌症患者和非癌症患者进行了倾向评分1:4匹配（PSM）。采用Kaplan-Meier法计算生存率，并通过对数秩检验比较差异。PSM分析产生了16例癌症患者和64例倾向评分匹配的非癌症患者。与非癌症患者相比，癌症患者往往有白细胞减少以及高敏C反应蛋白（hs-CRP）和降钙素原升高。对于COVID-19重症患者，癌症患者的生存率低于非癌症患者。此外，与轻度COVID-19患者相比，患有重度/重症COVID-19的癌症患者往往为男性，入院时SO和白蛋白水平较低，hs-CRP、乳酸脱氢酶和血尿素氮水平较高。在风险因素方面，近期癌症诊断（COVID-19发病1年内）以及COVID-19诊断后3个月内的抗肿瘤治疗与较差的生存率相关。我们发现，与非癌症患者相比，合并癌症的COVID-19患者具有独特的临床特征。重要的是，发现COVID-19重症癌症患者的预后比非癌症患者更差。在癌症队列中，重度/重症COVID-19患者与轻度COVID-19患者的临床特征不同；癌症病史短和近期接受抗癌治疗与较差的生存率相关。
