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2020 年巴西癌症合并 COVID-19 患者的严重程度和院内死亡率更高:二次数据分析全国情况。

Higher severity and risk of in-hospital mortality for COVID-19 patients with cancer during the year 2020 in Brazil: A countrywide analysis of secondary data.

机构信息

Department of Teaching and Research, Pernambuco Cancer Hospital, Recife, Brazil.

Department of Pneumology, Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil.

出版信息

Cancer. 2021 Nov 15;127(22):4240-4248. doi: 10.1002/cncr.33832. Epub 2021 Aug 3.

Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) and cancer are serious public health problems worldwide. However, little is known about the risk factors of in-hospital mortality among COVID-19 patients with and without cancer in Brazil. The objective of this study was to evaluate the risk factors of in-hospital mortality among COVID-19 patients with and without cancer and to compare mortality according to gender and topography during the year 2020 in Brazil.

METHODS

This was a secondary data study of hospitalized adult patients with a diagnosis of COVID-19 by real-time polymerase chain reaction testing in Brazil. The data were collected from the Influenza Epidemiological Surveillance Information System.

RESULTS

This study analyzed data from 322,817 patients. The prevalence of cancer in patients with COVID-19 was 2.3%. COVID-19 patients with neurological diseases and cancer had the most lethal comorbidities in both sexes. COVID-19 patients with cancer were more likely to be older (median age, 67 vs 62 years; P < .001), to have a longer hospital stay (13.1 vs 11.5 days; P < .001), to be admitted to the intensive care unit (45.3% vs 39.6%; P < .001), to receive more invasive mechanical ventilation (27.1% vs 21.9%), and to have a higher risk of death (adjusted odds ratio [aOR], 1.94; 95% confidence interval [CI], 1.83-2.06; P < .001) than those without cancer. Patients with hematological neoplasia (aOR, 2.85; 95% CI, 2.41-3.38; P < .001) had a higher risk of mortality than those with solid tumors (aOR, 1.83; 95% CI, 1.72-1.95; P < .001) in both sexes.

CONCLUSIONS

Brazilian COVID-19 patients with cancer have higher disease severity and a higher risk of mortality than those without cancer.

摘要

背景

2019 年冠状病毒病(COVID-19)和癌症是全球严重的公共卫生问题。然而,人们对巴西 COVID-19 合并和不合并癌症患者住院死亡率的危险因素知之甚少。本研究的目的是评估巴西 COVID-19 合并和不合并癌症患者住院死亡率的危险因素,并比较 2020 年男女患者和不同部位死亡率的差异。

方法

这是一项在巴西进行的实时聚合酶链反应检测确诊 COVID-19 的成年住院患者的二级数据研究。数据来自流感流行病学监测信息系统。

结果

本研究分析了 322817 例患者的数据。COVID-19 患者中癌症的患病率为 2.3%。COVID-19 合并神经系统疾病和癌症的患者在两性中具有最致命的合并症。COVID-19 合并癌症的患者更有可能年龄较大(中位数年龄 67 岁比 62 岁;P <.001)、住院时间较长(13.1 天比 11.5 天;P <.001)、入住重症监护病房(45.3%比 39.6%;P <.001)、接受更多有创机械通气(27.1%比 21.9%),并且死亡风险更高(调整后的优势比[aOR],1.94;95%置信区间[CI],1.83-2.06;P <.001)。与无癌症患者相比,患有血液系统恶性肿瘤的患者(aOR,2.85;95%CI,2.41-3.38;P <.001)和患有实体肿瘤的患者(aOR,1.83;95%CI,1.72-1.95;P <.001)的死亡率更高。

结论

巴西 COVID-19 合并癌症的患者疾病严重程度更高,死亡率高于不合并癌症的患者。

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