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[血液系统恶性肿瘤患者医院获得性新型冠状病毒肺炎严重程度危险因素的回顾性分析]

[A retrospective analysis of risk factors for severity of nosocomial COVID-19 in patients with hematological malignancy].

作者信息

Tsukada Nodoka, Inamura Junki, Igarashi Sho, Sato Kazuya

机构信息

Department of Hematology/Oncology, Asahikawa Kosei General Hospital.

出版信息

Rinsho Ketsueki. 2021;62(10):1474-1481. doi: 10.11406/rinketsu.62.1474.

Abstract

BACKGROUND

With the global spread of coronavirus disease 2019 (COVID-19), patients with cancer may be at a higher risk of suffering from COVID-19. Although patients with hematological malignancy (HM) are reported to have a higher risk of severe COVID-19 compared with those with solid cancer, the effects of treatment for HM on COVID-19 severity have not been fully elucidated.

METHODS

We retrospectively analyzed the risk factors, including number and timing of chemotherapeutic regimens for HM, for COVID-19 severity in 17 patients with HM, who had developed nosocomial COVID-19 in our department, by dividing them into two groups; a severe group (N=7) and a non-severe group (N=10).

RESULTS

The overall mortality rate was 47%, and mortality in the severe group was significantly higher than that in the non-severe group (odds ratio [OR], 18.44; 95% confidence interval [CI], 1.27-1223.17, P=0.02). Univariate analysis identified two or more chemotherapeutic regimens for HM (OR, 17.34; 95%CI, 1.15-1165.33, P=0.03) and a low hemoglobin level (P=0.02) as significant risk factors for COVID-19 severity. However, a history of chemotherapy for HM within 3 months prior to the onset of COVID-19 was not a significant risk factor (P=0.54).

CONCLUSION

A history of multiple chemotherapeutic regimens in patients with HM may be a risk factor for COVID-19 severity, and physicians should be aware of this.

摘要

背景

随着2019冠状病毒病(COVID-19)在全球蔓延,癌症患者感染COVID-19的风险可能更高。尽管据报道血液系统恶性肿瘤(HM)患者患重症COVID-19的风险高于实体癌患者,但HM治疗对COVID-19严重程度的影响尚未完全阐明。

方法

我们回顾性分析了在我科发生医院获得性COVID-19的17例HM患者中,包括HM化疗方案的次数和时间等COVID-19严重程度的危险因素,将他们分为两组:重症组(N = 7)和非重症组(N = 10)。

结果

总死亡率为47%,重症组的死亡率显著高于非重症组(优势比[OR],18.44;95%置信区间[CI],1.27 - 1223.17,P = 0.02)。单因素分析确定HM的两种或更多化疗方案(OR,17.34;95%CI,1.15 - 1165.33,P = 0.03)和低血红蛋白水平(P = 0.02)是COVID-19严重程度的重要危险因素。然而,COVID-19发病前3个月内HM化疗史不是显著危险因素(P = 0.54)。

结论

HM患者的多次化疗史可能是COVID-19严重程度的危险因素,医生应予以关注。

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