Tsukada Nodoka, Inamura Junki, Igarashi Sho, Sato Kazuya
Department of Hematology/Oncology, Asahikawa Kosei General Hospital.
Rinsho Ketsueki. 2021;62(10):1474-1481. doi: 10.11406/rinketsu.62.1474.
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.
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).
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).
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.
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。
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)。
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)。
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。