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感染新型冠状病毒的癌症患者的预后因素:一个拉丁美洲国家的研究结果。

Prognostic factors in cancer patients infected with SARS-CoV-2: a Latin American country results.

作者信息

Ruiz-Garcia Erika, Peña-Nieves Adriana, Alegria-Baños Jorge, Cornejo-Juarez Patricia, Meneses-García Abelardo, Rivera Samuel Rivera, Sánchez Juan José, Gerson-Cwilich Raquel, Gerson Daniela Shveid, Franco Heriberto Medina, Buerba Gabriela Alejandra, Espinoza Alicia Acosta, Mijares Norma Valencia, Fernández-Figueroa Edith A, Vázquez Roberto A, Vilar-Compte Diana

机构信息

Department of Medical Oncology & Translational Medicine Laboratory, Instituto Nacional de Cancerología, Av. San Fernando N. 22, ZC 14080 Mexico City, Mexico.

Translational Medicine Laboratory, Instituto Nacional de Cancerología, Mexico City, Mexico.

出版信息

Ther Adv Chronic Dis. 2021 Sep 26;12:20406223211047755. doi: 10.1177/20406223211047755. eCollection 2021.

Abstract

PURPOSE

The aim of this study was to evaluate the demographic characteristics, clinical and pathological factors, and the outcome of cancer and COVID-19 patients in Mexico.

PATIENTS AND METHODS

A prospective, multicentric study was performed through a digital platform to have a national registry of patients with cancer and positive SARS-CoV-2 test results through reverse transcription quantitative polymerase chain reaction (RT-qPCR). We performed the analysis through a multivariate logistic regression model and Cox proportional hazard model.

RESULTS

From May to December 2020, 599 patients were registered with an average age of 56 years with 59.3% female; 27.2% had hypertension. The most frequent diagnoses were breast cancer (30.4%), lymphoma (14.7%), and colorectal cancer (14.0%); 72.1% of patients had active cancer and 23.5% of patients (141/599) were deceased, the majority of which were men (51.7%). This study found that the prognostic factors that reduced the odds of death were gender (OR = 0.42,  = 0.031) and oxygen saturation (OR = 0.90,  = 0.0001); meanwhile, poor ECOG (OR = 5.4,  = 0.0001), active disease (OR = 3.9,  = 0.041), dyspnea (OR = 2.5,  = 0.027), and nausea (OR = 4.0,  = 0.028) increased the odds of death. In the meantime, the factors that reduce survival time were age (HR = 1.36,  = 0.035), COPD (HR = 8.30,  = 0.004), having palliative treatment (HR = 10.70,  = 0.002), and active cancer without treatment (HR = 8.68,  = 0.008).

CONCLUSION

Mortality in cancer patients with COVID-19 is determined by prognostic factors whose identification is necessary. In our cancer population, we have observed that being female, younger, non-COPD, with non-active cancer, good performance status, and high oxygen levels reduce the probability of death.

摘要

目的

本研究旨在评估墨西哥癌症患者和新冠肺炎患者的人口统计学特征、临床和病理因素以及预后情况。

患者与方法

通过数字平台开展了一项前瞻性多中心研究,以建立一个通过逆转录定量聚合酶链反应(RT-qPCR)检测出SARS-CoV-2呈阳性的癌症患者全国登记册。我们通过多变量逻辑回归模型和Cox比例风险模型进行分析。

结果

2020年5月至12月,登记了599例患者,平均年龄56岁,女性占59.3%;27.2%患有高血压。最常见的诊断为乳腺癌(30.4%)、淋巴瘤(14.7%)和结直肠癌(14.0%);72.1%的患者患有活动性癌症,23.5%的患者(141/599)死亡,其中大多数为男性(51.7%)。本研究发现,降低死亡几率的预后因素为性别(OR = 0.42,P = 0.031)和血氧饱和度(OR = 0.90,P = 0.0001);同时,美国东部肿瘤协作组(ECOG)评分差(OR = 5.4,P = 0.0001)、疾病活动(OR = 3.9,P = 0.041)、呼吸困难(OR = 2.5,P = 0.027)和恶心(OR = 4.0,P = 0.028)会增加死亡几率。同时,缩短生存时间的因素为年龄(HR = 1.36,P = 0.035)、慢性阻塞性肺疾病(COPD)(HR = 8.30,P = 0.004)、接受姑息治疗(HR = 10.70,P = 0.002)以及患有未经治疗的活动性癌症(HR = 8.68,P = 0.008)。

结论

新冠肺炎癌症患者的死亡率由预后因素决定,识别这些因素很有必要。在我们的癌症患者群体中,我们观察到女性、年轻、无COPD、无活动性癌症、身体状况良好以及血氧水平高会降低死亡概率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2423/8481715/185cd5c76090/10.1177_20406223211047755-fig1.jpg

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