Payet Eduardo, Perez Joan, Sarria Gustavo, Neciosup Silvia, Berrospi Francisco, Vilchez Sheila, Dunstan Jorge, Perez Ronald, Vassallo Mauricio, Salgado Santiago, Caparachín Nanto, Pinto Joseph A, Holguin Alexis
Departamento de Cirugía en Abdomen, Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520, Surquillo, Lima 34, Peru.
Departamento de Cirugía Ginecológica, Instituto Nacional de Enfermedades Neoplásicas, Av Angamos 2520, Surquillo, Lima 34, Peru.
Ecancermedicalscience. 2021 Jun 10;15:1246. doi: 10.3332/ecancer.2021.1246. eCollection 2021.
Cancer patients are at higher risk of infection and severity of Coronavirus Disease-19 (COVID-19). Management of patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is challenging due to the scarce scientific information and treatment guidelines. In this work, we present our Institutional experience with our first 100 patients with oncological malignancies and COVID-19.
We conducted a cross-sectional study of the first 100 patients hospitalised at the Instituto Nacional de Enfermedades Neoplasicas (Lima, Peru) who were positive for SARS-CoV-2 by reverse transcriptase (RT)-PCR during the period 30 March to 20 June. Clinicopathological variables of the oncological disease as well as risk factors, management and outcomes to COVID-19 were evaluated.
The mean age was 43.5 years old (standard deviations: ±24.8) where 57% were male patients. In total, 44%, 37% and 19% were adult patients bearing solid tumours, adults with haematologic malignancies and paediatric patients, respectively. Hypertension was the most frequent comorbidity (23%) followed by chronic lung disease (10%). COVID-19-associated symptoms included cough (65%), fever (57%) and dyspnoea (56%). Twelve percent of patients were asymptomatic. Nosocomial infections were more frequent in paediatric patients (84.2%) than in adult patients (16.0%). Patients with uncontrolled oncological disease were most frequent (72%). Anaemia was present in 67% of patients, 68% had lymphopenia, 62% had ferritin value > 500 mcg/L, 85% had elevated lactate dehydrogenase (LDH), 83% D-dimer > 500 ng/mL and 80% C-Reactive Protein > 8 mg/L. The most common complication was acute respiratory failure (42%). Overall fatality rate was 39% where the main cause of mortality was acute respiratory distress syndrome (64.1%).
Paediatric patients had better outcomes than adult populations, and a high number of asymptomatic carriers and nosocomial infection, early diagnosis are recommended. Considering oncological treatments 30 days before COVID-19 diagnosis, our data did not reveal an increased mortality.
癌症患者感染新型冠状病毒肺炎（COVID-19）的风险更高，病情也更严重。由于科学信息和治疗指南匮乏，对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染患者的管理具有挑战性。在这项研究中，我们介绍了我们机构对首批100例肿瘤恶性肿瘤合并COVID-19患者的经验。
我们对3月30日至6月20日期间在秘鲁利马国家肿瘤研究所住院的首批100例经逆转录酶（RT）-PCR检测SARS-CoV-2呈阳性的患者进行了横断面研究。评估了肿瘤疾病的临床病理变量以及COVID-19的危险因素、管理和结局。
平均年龄为43.5岁（标准差：±24.8），其中57%为男性患者。总体而言，分别有44%、37%和19%为患有实体瘤的成年患者、患有血液系统恶性肿瘤的成年患者和儿科患者。高血压是最常见的合并症（23%），其次是慢性肺病（10%）。COVID-19相关症状包括咳嗽（65%）、发热（57%）和呼吸困难（56%）。12%的患者无症状。儿科患者的医院感染（84.2%）比成年患者（16.0%）更常见。肿瘤疾病未得到控制的患者最为常见（72%）。67%的患者存在贫血，68%的患者淋巴细胞减少，62%的患者铁蛋白值>500 mcg/L，85%的患者乳酸脱氢酶（LDH）升高，83%的患者D-二聚体>500 ng/mL，80%的患者C反应蛋白>8 mg/L。最常见的并发症是急性呼吸衰竭（42%）。总体死亡率为39%，主要死亡原因是急性呼吸窘迫综合征（64.1%）。
儿科患者的结局优于成年人群，建议对大量无症状携带者和医院感染进行早期诊断。考虑到COVID-19诊断前30天的肿瘤治疗，我们的数据未显示死亡率增加。
