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癌症合并 COVID-19 患者入院时的预后因素:HOPE 登记数据分析。

Prognostic factors at admission on patients with cancer and COVID-19: Analysis of HOPE registry data.

机构信息

Medical Oncology Dpt. Hospital Clinico San Carlos, Madrid, Spain.

Medical Oncology Dpt. Hospital Clinico San Carlos, Madrid, Spain.

出版信息

Med Clin (Barc). 2021 Oct 8;157(7):318-324. doi: 10.1016/j.medcli.2021.02.021. Epub 2021 May 6.

Abstract

BACKGROUND

Previous works seem to agree in the higher mortality of cancer patients with COVID-19. Identifying potential prognostic factors upon admission could help identify patients with a poor prognosis.

METHODS

We aimed to explore the characteristics and evolution of COVID-19 cancer patients admitted to hospital in a multicenter international registry (HOPE COVID-19). Our primary objective is to define those characteristics that allow us to identify cancer patients with a worse prognosis (mortality within 30 days after the diagnosis of COVID-19).

RESULTS

5838 patients have been collected in this registry, of whom 770 had cancer among their antecedents. In hospital mortality reached 258 patients (33.51%). The median was 75 years (65-82). Regarding the distribution by sex, 34.55% of the patients (266/770) were women. The distribution by type of cancer: genitourinary 238/745 (31.95%), digestive 124/745 (16.54%), hematologic 95/745 (12.75%). In multivariate regression analysis, factors that are independently associated with mortality at admission are: renal impairment (OR 3.45, CI 97.5% 1.85-6.58), heart disease (2.32, 1.47-3.66), liver disease (4.69, 1.94-11.62), partial dependence (2.41, 1.34-4.33), total dependence (7.21, 2.60-21.82), fatigue (1.84, 1.16-2.93), arthromialgias (0.45, 0.26-0.78), SatO2<92% (4.58, 2.97-7.17), elevated LDH (2.61, 1.51-4.69) and abnormal decreased Blood Pressure (3.57, 1.81-7.15). Analitical parameters are also significant altered.

CONCLUSION

In patients with cancer from the HOPE registry, 30-day mortality from any cause is high and is associated with easily identifiable clinical factors upon arrival at the hospital. Identifying these patients can help initiate more intensive treatments from the start and evaluate the prognosis of these patients.

摘要

背景

先前的研究似乎都表明,COVID-19 癌症患者的死亡率更高。在入院时确定潜在的预后因素有助于识别预后不良的患者。

方法

我们旨在通过多中心国际登记处(HOPE COVID-19)探讨 COVID-19 癌症住院患者的特征和演变。我们的主要目的是确定那些能够识别预后较差的癌症患者的特征(COVID-19 诊断后 30 天内死亡)。

结果

该登记处共收录了 5838 例患者,其中 770 例有癌症病史。住院死亡率为 258 例(33.51%)。中位年龄为 75 岁(65-82 岁)。按性别分布,770 例癌症患者中,女性 34.55%(266/770)。按癌症类型分布:泌尿生殖系统 238/745(31.95%),消化系统 124/745(16.54%),血液系统 95/745(12.75%)。多变量回归分析表明,入院时与死亡率独立相关的因素有:肾功能不全(OR 3.45,97.5%CI 1.85-6.58),心脏病(2.32,1.47-3.66),肝病(4.69,1.94-11.62),部分依赖(2.41,1.34-4.33),完全依赖(7.21,2.60-21.82),疲劳(1.84,1.16-2.93),关节痛(0.45,0.26-0.78),SatO2<92%(4.58,2.97-7.17),升高的 LDH(2.61,1.51-4.69)和异常低血压(3.57,1.81-7.15)。分析参数也有显著改变。

结论

在 HOPE 登记处的癌症患者中,任何原因导致的 30 天死亡率较高,且与入院时易识别的临床因素相关。识别这些患者有助于从一开始就开始更积极的治疗,并评估这些患者的预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/055c/8101784/2f415a5bdb37/gr1_lrg.jpg

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