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基于全球数据网络的 COVID-19 对多发性骨髓瘤患者的影响。

Impact of COVID-19 in patients with multiple myeloma based on a global data network.

机构信息

Hematology Department, Hospital 12 de Octubre, Complutense University, CNIO, Madrid, Spain.

Biomedical Informatics Group, Universidad Politécnica de Madrid, Madrid, Spain.

出版信息

Blood Cancer J. 2021 Dec 10;11(12):198. doi: 10.1038/s41408-021-00588-z.

Abstract

The COVID-19 pandemic has represented a major cause of morbidity/mortality worldwide, overstressing health systems. Multiple myeloma (MM) patients show an increased risk for infections and they are expected to be particularly vulnerable to SARS-CoV-2 infection. Here we have obtained a comprehensive picture of the impact of COVID-19 in MM patients on a local and a global scale using a federated data research network (TriNetX) that provided access to Electronic Medical Records (EMR) from Health Care Organizations (HCO) all over the world. Through propensity score matched analyses we found that the number of new diagnoses of MM was reduced in 2020 compared to 2019 (RR 0.86, 95%CI 0.76-0.96) and the survival of newly diagnosed MM cases decreased similarly (HR 0.61, 0.38-0.81). MM patients showed higher risk of SARS-CoV-2 infection (RR 2.09, 1.58-2.76) and a higher excess mortality in 2020 (difference in excess mortality 9%, 4.4-13.2) than non-MM patients. By interrogating large EMR datasets from HCO in Europe and globally, we confirmed that MM patients have been more severely impacted by COVID-19 pandemic than non-MM patients. This study highlights the necessity of extending preventive measures worlwide to protect vulnerable patients from SARS-CoV-2 infection by promoting social distancing and an intensive vaccination strategies.

摘要

COVID-19 大流行是全球发病和死亡的主要原因,使卫生系统不堪重负。多发性骨髓瘤(MM)患者感染风险增加,预计特别容易感染 SARS-CoV-2。在这里,我们使用一个联合数据研究网络(TriNetX),从世界各地的医疗保健组织(HCO)获取电子病历(EMR),从本地和全球范围全面了解 COVID-19 对 MM 患者的影响。通过倾向评分匹配分析,我们发现与 2019 年相比,2020 年 MM 的新诊断数量减少(RR 0.86,95%CI 0.76-0.96),新诊断 MM 病例的生存率也相似下降(HR 0.61,0.38-0.81)。MM 患者感染 SARS-CoV-2 的风险更高(RR 2.09,1.58-2.76),2020 年的超额死亡率也更高(超额死亡率差异 9%,4.4-13.2)。通过调查来自欧洲和全球 HCO 的大型 EMR 数据集,我们证实 MM 患者比非 MM 患者受到 COVID-19 大流行的严重影响。这项研究强调,有必要在全球范围内扩大预防措施,通过促进社交距离和强化疫苗接种策略,保护弱势群体免受 SARS-CoV-2 感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c323/8664903/aa73c34b005c/41408_2021_588_Fig1_HTML.jpg

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