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实体瘤患者中2019冠状病毒病的临床表现及转归

Clinical Presentations and Outcomes of Coronavirus Disease 2019 in Patients With Solid Tumors.

作者信息

Farooque Imran, Farooque Umar, Karimi Sundas, Syed Muhammad Usman Shah, Nadeem Zubia, Zulfiqar Arif, Mustafa Sufyan, Farooque Rizwan, Sultan Ayyaz A, Hassan Syed Adeel

机构信息

Public Health, Peoples University of Medical and Health Sciences for Women, Nawabshah, PAK.

Neurology, Dow University of Health Sciences, Karachi, PAK.

出版信息

Cureus. 2021 Jun 5;13(6):e15452. doi: 10.7759/cureus.15452. eCollection 2021 Jun.

Abstract

Background Coronavirus disease 2019 (COVID-19) is a global health crisis. The literature suggests that cancer patients are more prone to be affected by COVID-19 because cancer suppresses the immune system and such patients usually present poor results. The objective of this study is to present all clinical, laboratory, and demographic characteristics of COVID-19 patients with solid tumors. Methodology This study was conducted at the Dow University of Health Sciences for a period of six months from April 2020 to September 2020. In this study, we included a total of 1,519 confirmed patients diagnosed with solid tumors via polymerase chain reaction. The mortality timeline within 30 days of contracting the virus was considered, and the median age of the included individuals was 61 years, with a range of 20-95 years. Of the patients included in the study, 49.4% (750) were men; moreover, 3.15% of our study population had prostate cancer, 10.20% had colorectal cancer, 2.76% had breast cancer, and 10.46% had lung cancer. Of the patients, 25.93% presented with at least one comorbidity. For 73% of the patients, at least one direct therapy for COVID-19 was included in the treatment; 56.6% of the patients were hospitalized, and 11.32% were admitted to the intensive care unit. Results The mortality rate was 4.74% in the first 30 days after diagnosis, where 72 patients died. The findings of the first multi-variation model showed that males at older ages who were diabetic and going through cytotoxic therapy were prone to die within the first 30 days. However, the 30-day mortality rate was lower in patients diagnosed with prostate and breast cancer. The second set incorporated laboratory factors, where we found that higher values of leukocytosis, thrombocytopenia, and lymphocytopenia were correlated with higher rates of mortality within 30 days. Conclusions We conclude that there is a higher mortality rate of COVID-19 in patients with solid tumors than in the general population. However, it was found to be lower in the Pakistani population compared with the Chinese and Western populations. Intensive care can decrease mortality rates in COVID-19 and cancer patients.

摘要

背景 2019 冠状病毒病(COVID-19)是一场全球健康危机。文献表明,癌症患者更容易受到 COVID-19 的影响,因为癌症会抑制免疫系统,且这类患者通常预后不佳。本研究的目的是呈现实体瘤 COVID-19 患者的所有临床、实验室和人口统计学特征。方法 本研究于 2020 年 4 月至 2020 年 9 月在道健康科学大学进行,为期六个月。在本研究中,我们纳入了总共 1519 例经聚合酶链反应确诊为实体瘤的患者。考虑了感染病毒后 30 天内的死亡率时间线,纳入个体的中位年龄为 61 岁,年龄范围为 20 - 95 岁。在纳入研究的患者中,49.4%(750 例)为男性;此外,我们研究人群中 3.15%患有前列腺癌,10.20%患有结直肠癌,2.76%患有乳腺癌,10.46%患有肺癌。在这些患者中,25.93%至少有一种合并症。73%的患者在治疗中至少接受了一种针对 COVID-19 的直接治疗;56.6%的患者住院治疗,11.32%的患者入住重症监护病房。结果 诊断后前 30 天的死亡率为 4.74%,有 72 例患者死亡。第一个多变量模型的结果显示,年龄较大、患有糖尿病且正在接受细胞毒性治疗的男性在最初 30 天内更容易死亡。然而,被诊断患有前列腺癌和乳腺癌的患者 30 天死亡率较低。第二组纳入了实验室因素,我们发现白细胞增多、血小板减少和淋巴细胞减少的较高值与 30 天内较高的死亡率相关。结论 我们得出结论,实体瘤患者中 COVID-19 的死亡率高于一般人群。然而,与中国和西方人群相比,巴基斯坦人群中的死亡率较低。重症监护可以降低 COVID-19 和癌症患者的死亡率。

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