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与实体瘤患者相比,血液系统癌症患者更容易感染 COVID-19。

Patients with hematologic cancers are more vulnerable to COVID-19 compared to patients with solid cancers.

机构信息

Department of Hematology and Bone Marrow Transplantation Center, Ankara Oncology Training and Research Hospital, University of Health Sciences, Ankara, Turkey.

Department of Strategy Development, Republic of Turkey, Ministry of Health, Ankara, Turkey.

出版信息

Intern Emerg Med. 2022 Jan;17(1):135-139. doi: 10.1007/s11739-021-02784-y. Epub 2021 Jun 10.

Abstract

Previous studies reported that COVID-19 patients with cancer had higher rates of severe events such as intensive care unit (ICU) admission, mechanical ventilation (MV) assistance, and death during the COVID-19 course compared to the general population. However, no randomized study compared the clinical course of COVID-19 in patients with hematologic cancers to patients with solid cancers. Thus, in this study, we intend to reveal the outcome of COVID-19 in hematologic cancer patients and compare their outcomes with COVID-19 patients with solid cancers. The data of 926 laboratory-confirmed COVID-19 patients, including 463 hematologic cancer patients and an age-gender paired cohort of 463 solid cancer patients, were investigated retrospectively. The frequencies of severe and critical disease, hospital and ICU admission, MV assistance were significantly higher in hematologic cancer patients compared with the solid cancer patients (p = 0.001, p = 0.045, p = 0.001, and p = 0.001, respectively). The hospital stay was longer in patients with hematologic cancers (p = 0.001); however, the median ICU stay was 6 days in both groups. The case fatality rate (CFR) was 14.9% in patients with hematologic cancers, and it was 4.8% in patients with solid cancers, and there was a statistically significant difference regarding CFR between groups (p = 0.001). Our study revealed that COVID-19 patients with hematologic cancers have a more aggressive course of COVID-19 and have higher CFR compared to COVID-19 patients with solid cancers and support the increased susceptibility of patients with hematologic cancers during the outbreak.

摘要

先前的研究报告指出,与普通人群相比,COVID-19 合并癌症患者在 COVID-19 病程中出现重症事件(如入住重症监护病房(ICU)、接受机械通气(MV)辅助和死亡)的比例更高。然而,尚无随机研究比较血液系统癌症患者与实体瘤癌症患者 COVID-19 的临床病程。因此,在这项研究中,我们旨在揭示血液系统癌症患者 COVID-19 的结局,并将其与实体瘤癌症患者 COVID-19 的结局进行比较。我们回顾性调查了 926 例经实验室确诊的 COVID-19 患者的数据,包括 463 例血液系统癌症患者和 463 例年龄和性别相匹配的实体瘤癌症患者。与实体瘤癌症患者相比,血液系统癌症患者重症和危重症疾病、住院和入住 ICU、MV 辅助的频率显著更高(p=0.001、p=0.045、p=0.001 和 p=0.001)。血液系统癌症患者的住院时间更长(p=0.001);然而,两组患者的 ICU 中位住院时间均为 6 天。血液系统癌症患者的病死率(CFR)为 14.9%,而实体瘤癌症患者的 CFR 为 4.8%,两组间 CFR 存在统计学差异(p=0.001)。我们的研究表明,COVID-19 合并血液系统癌症患者 COVID-19 的病程更具侵袭性,CFR 高于 COVID-19 合并实体瘤癌症患者,并且支持在疫情期间血液系统癌症患者的易感性增加。

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