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[新冠病毒肺炎住院癌症患者的临床结局]

[Clinical outcomes in cancer patients hospitalized with COVID-19].

作者信息

Zylberman Marcelo, Díaz-Couselo Fernando A, Irrazabal Célica, Flagel Santiago, Custidiano Rosario, Racciopi Agustina, Nicolini Carla, Bachetti Pierina, Rébora Juan, Manzano Natalia, Tavella Margarita, Valle Sandra, Noro Laura, Halac Sebastián, Cassal Eric, Paganini Lisandro, Aguirre Marina, Dictar Miguel

机构信息

Instituto Alexander Fleming, Buenos Aires, Argentina. E-mail:

Instituto Alexander Fleming, Buenos Aires, Argentina.

出版信息

Medicina (B Aires). 2021;81(5):695-702.

Abstract

Cancer patients are exposed to more complications from COVID-19 than non-cancer patients. We report a cohort of 74 cancer patients (87.8% with solid neoplasia and 12.2% with hematological diseases) with COVID-19 infection admitted to a tertiary medical cancer center in Argentina. Pulmonary infiltrates were diagnosed at admission in 78.3% (N = 58) of the cases. COVID-19 infection was hospital-acquired in 20 (27.0%) patients. Thirty-nine patients (52.7%) received anticancer therapy within the 30 days prior to COVID-19 diagnosis; one was on radiation therapy. Twenty-four (32.4%) patients were admitted in the intensive care unit (ICU) and 18 (75.0%) required mechanical ventilation. All cause in-hospital mortality was 32.4% (N = 24) and ICU mortality was 62.5% (N = 15). Mortality under mechanical ventilation was 72.2% (N = 13). In the univariate analysis age, neutrophil count, neutrophil/lymphocyte index, D-dimer, ferritin, smoking, and nosocomial acquired infection were associated with in-hospital mortality. There were no statistically significant differences in mortality related to disease stage for solid tumors, neither cancer treatment within 30 days of COVID-19 diagnosis. Age and smoking were associated with mortality in the multivariate analysis. The adjusted odds ratios (95 CI) for age = 65 years and smoking were 8.87 (1.35-58.02) and 8.64 (1.32 - 56.64), respectively. Our experience can be useful for other institutions that assist cancer patients during the pandemic.

摘要

癌症患者比非癌症患者更容易因感染新冠病毒而出现更多并发症。我们报告了一组74例感染新冠病毒的癌症患者(87.8%为实体瘤,12.2%为血液系统疾病),他们被收治于阿根廷一家三级医疗癌症中心。78.3%(N = 58)的病例在入院时被诊断为肺部浸润。20例(27.0%)患者的新冠病毒感染为医院获得性感染。39例(52.7%)患者在新冠病毒诊断前30天内接受了抗癌治疗;1例接受放疗。24例(32.4%)患者被收入重症监护病房(ICU),18例(75.0%)需要机械通气。全因院内死亡率为3

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