Department of Oncology, "Prof. Dr. Alexandru Trestioreanu" Oncology Institute, Bucharest, Romania.
Department of Oncology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
In Vivo. 2022 Mar-Apr;36(2):934-941. doi: 10.21873/invivo.12783.
BACKGROUND/AIM: This study aimed to assess the impact of the ongoing COVID-19 pandemic on cancer patients, known to be immune-compromised due to the disease itself, oncological treatments and adjuvant medicines use such as steroids. Overall survival was determined for patients with COVID-19 infection and stratification according to known comorbidities and complications was performed.
This prospective study included ninety cancer patients with COVID-19 confirmed by PCR testing performed before each cycle of chemotherapy or every two weeks during radiotherapy between May and December 2020 in two tertiary Cancer Centers. Demographic, cancer-related and SARS-CoV-2 infection data were collected and long-term oncologic outcome was assessed.
Mean age of cancer patients diagnosed with SARS-CoV-2 was 59.7±12.1 years (range=30-83 years). Fifty-two (57.7%) were women. The most frequent cancer localization was breast (n=28, 31.1%) followed by colorectal (n=11, 12.2%) and lung cancer (n=8, 8.8%). Most patients infected with SARS-CoV-2 were diagnosed in stage IV of the disease (n=44, 48.9%) followed by stage III (n=19, 21.1%) and stage II disease (18.9%). Regarding comorbidities, the most common was hypertension (n=31) followed by cardiac dysfunction (n=23) and type II diabetes (n=13). Of 27 (30%) patients who needed hospitalization, 4 patients developed severe infection, 17 patients had mild symptoms and 6 patients were minimally symptomatic. After a median follow-up of 22.5 months, 5 patients (5.55%) died due to SARS-COV-2 infection, all stages III and IV. Median estimated overall survival was 14 months in patients who died because of COVID infection compared to 98 months in cancer-related mortality analysis (p<0.0001). Three deaths occurred during chemotherapy, 1 death in the chemoradiotherapy radiotherapy group.
SARS-CoV-2 infection was associated with an excess mortality in our study population, especially in patients with advanced and metastatic disease and in those receiving immunosuppressive treatment such as chemotherapy and radiotherapy.
背景/目的：本研究旨在评估正在进行的 COVID-19 大流行对癌症患者的影响，这些患者由于自身疾病、肿瘤治疗和类固醇等辅助药物的使用而免疫功能低下。我们确定了 COVID-19 感染患者的总体生存率，并根据已知的合并症和并发症进行了分层。
本前瞻性研究纳入了 2020 年 5 月至 12 月期间在两家三级癌症中心接受每周期化疗前或放疗期间每两周进行的 PCR 检测确诊为 COVID-19 的 90 例癌症患者。收集了人口统计学、癌症相关和 SARS-CoV-2 感染数据，并评估了长期肿瘤学结局。
诊断为 SARS-CoV-2 的癌症患者的平均年龄为 59.7±12.1 岁（范围 30-83 岁）。52 例（57.7%）为女性。最常见的癌症部位是乳腺（n=28，31.1%），其次是结直肠（n=11，12.2%）和肺癌（n=8，8.8%）。大多数感染 SARS-CoV-2 的患者被诊断为疾病 IV 期（n=44，48.9%），其次是 III 期（n=19，21.1%）和 II 期疾病（n=18.9%）。关于合并症，最常见的是高血压（n=31），其次是心功能不全（n=23）和 2 型糖尿病（n=13）。在需要住院治疗的 27 例（30%）患者中，4 例患者发生严重感染，17 例患者有轻度症状，6 例患者有轻微症状。中位随访 22.5 个月后，5 例（5.55%）患者因 SARS-COV-2 感染死亡，均为 III 期和 IV 期。与癌症相关死亡率分析相比，因 COVID 感染死亡的患者中位估计总生存期为 14 个月（p<0.0001）。3 例死亡发生在化疗期间，1 例死亡发生在化疗联合放疗组。
在我们的研究人群中，SARS-CoV-2 感染与死亡率升高相关，尤其是在晚期和转移性疾病患者以及接受化疗和放疗等免疫抑制治疗的患者中。
