Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA.
Oncologist. 2022 May 6;27(5):398-406. doi: 10.1093/oncolo/oyac038.
The risks associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated illness, coronavirus disease 2019 (COVID-19), among patients with a cancer diagnosis have not been fully characterized. This study leverages data from a multi-institutional cohort study, the University of California Cancer COVID Consortium, to evaluate outcomes associated with SARS-CoV-2 infection among patients with cancer.
Clinical data were collected from March to November 2020 and included patient demographics, cancer history and treatment, SARS-CoV-2 exposure and testing, and COVID-19 clinical management and outcomes. Multivariate ordinal logistic regression permitting unequal slopes was used to evaluate the impact of demographic, disease, and treatment factors on SARS-CoV-2 related hospitalization, intensive care unit (ICU) admission, and mortality.
Among all evaluated patients (n = 303), 147 (48%) were male, 118 (29%) were older adults (≥65 years old), and 104 (34%) were non-Hispanic white. A subset (n = 63, 21%) had hematologic malignancies and the remaining had solid tumors. Patients were hospitalized for acute care (n = 79, 26%), ICU-level care (n = 28, 9%), or died (n = 21, 7%) due to COVID-19. Patients with ≥2 comorbidities were more likely to require acute care (odds ratio [OR] 2.09 [95% confidence interval (CI), 1.23-3.55]). Cough was identified as a significant predictor of ICU hospitalization (OR 2.16 [95% CI, 1.03-4.57]). Importantly, mortality was associated with an active cancer diagnosis (OR 3.64 [95% CI, 1.40-9.5]) or advanced age (OR 3.86 [95% CI, 1.2-12.44]).
This study observed that patients with active cancer or advanced age are at an increased risk of death from COVID-19. These study observations can inform risk counseling related to COVID-19 for patients with a cancer diagnosis.
患有癌症诊断的患者与严重急性呼吸系统综合症冠状病毒 2（SARS-CoV-2）及其相关疾病 2019 年冠状病毒病（COVID-19）相关的风险尚未完全确定。本研究利用加利福尼亚大学癌症 COVID 联盟的多机构队列研究的数据，评估 SARS-CoV-2 感染与癌症患者相关的结局。
临床数据于 2020 年 3 月至 11 月收集，包括患者人口统计学、癌症病史和治疗、SARS-CoV-2 暴露和检测以及 COVID-19 临床管理和结局。使用允许不等斜率的多元有序逻辑回归评估人口统计学、疾病和治疗因素对 SARS-CoV-2 相关住院、重症监护病房（ICU）入院和死亡率的影响。
在所评估的所有患者中（n = 303），147 名（48%）为男性，118 名（29%）为老年人（≥65 岁），104 名（34%）为非西班牙裔白人。亚组（n = 63，21%）患有血液恶性肿瘤，其余患有实体瘤。患者因 COVID-19 接受急性护理（n = 79，26%）、重症监护病房（n = 28，9%）或死亡（n = 21，7%）。患有≥2 种合并症的患者更有可能需要急性护理（优势比[OR]2.09[95%置信区间（CI），1.23-3.55]）。咳嗽被确定为 ICU 住院的重要预测因素（OR 2.16[95%CI，1.03-4.57]）。重要的是，死亡率与活跃癌症诊断（OR 3.64[95%CI，1.40-9.5]）或年龄较大（OR 3.86[95%CI，1.2-12.44]）相关。
本研究观察到患有活动性癌症或年龄较大的患者死于 COVID-19 的风险增加。这些研究观察结果可以为癌症诊断患者提供与 COVID-19 相关的风险咨询。
