Aga Khan University Hospital, Karachi, Pakistan.
Department of Oncology, The Aga Khan University Hospital, Karachi, Pakistan.
PLoS One. 2022 Apr 21;17(4):e0267139. doi: 10.1371/journal.pone.0267139. eCollection 2022.
COVID-19 infection resulting from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began to spread across the globe in early 2020. Patients with hematologic malignancies are supposed to have an increased risk of mortality from coronavirus disease of 2019 (COVID-19) infection. From Pakistan, we report the analysis of the outcome and interaction between patient demographics and tumor subtype and COVID-19 infection and hematological malignancy.
This multicenter, retrospective study included adult patients with a history of histologically proven hematological malignancies who were tested positive for COVID-19 via PCR presented at the oncology department of 5 tertiary care hospitals in Pakistan from February to August 2020. A patient with any known hematological malignancy who was positive for COVID-19 on RT-PCR, was included in the study. Chi-square test and Cox-regression hazard regression model was applied considering p ≤ 0.05 significant.
A total of 107 patients with hematological malignancies were diagnosed with COVID-19, out of which 82 (76.64%) were alive, and 25 (23.36%) were dead. The significant hematological malignancy was B-cell Lymphoma in dead 4 (16.00%) and alive group 21 (25.61%), respectively. The majority of the patients in both the dead and alive group were on active treatment for hematological malignancy while they came positive for COVID-19 [21 (84.00%) & 48 (58.54%) p 0.020]. All patients in the dead group were admitted to the hospital 25 (100.00%), and among these, 14 (56.00%) were admitted in ICU with a median 11 (6-16.5) number of days. Among those who had contact exposure, the hazard of survival or death in patients with hematological malignancies and COVID-19 positive was 2.18 (CI: 1.90-4.44) times and 3.10 (CI: 2.73-4.60) times in patients with travel history compared to no exposure history (p 0.001).
Taken together, this data supports the emerging consensus that patients with hematologic malignancies experience significant morbidity and mortality resulting from COVID-19 infection.
由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起的 COVID-19 感染于 2020 年初开始在全球范围内传播。患有血液系统恶性肿瘤的患者应该有更高的 2019 年冠状病毒病(COVID-19)感染死亡率。本文来自巴基斯坦,我们报告了对患者人口统计学特征、肿瘤亚型以及 COVID-19 感染和血液系统恶性肿瘤之间的相互作用与结局进行分析。
这项多中心回顾性研究纳入了 2020 年 2 月至 8 月期间在巴基斯坦 5 家三级护理医院的肿瘤科就诊并经 PCR 检测确诊为 COVID-19 的经组织学证实患有血液系统恶性肿瘤的成年患者。任何已知患有血液系统恶性肿瘤且 RT-PCR 检测结果为 COVID-19 阳性的患者均纳入本研究。应用卡方检验和 Cox 回归风险回归模型,p≤0.05 为差异有统计学意义。
共有 107 例血液系统恶性肿瘤患者被诊断为 COVID-19,其中 82 例(76.64%)存活,25 例(23.36%)死亡。死亡组中显著的血液恶性肿瘤为 B 细胞淋巴瘤(4 例,16.00%),存活组为 B 细胞淋巴瘤(21 例,25.61%)。两组均有大多数患者在确诊 COVID-19 时正处于血液恶性肿瘤的积极治疗中[死亡组 21 例(84.00%)和存活组 48 例(58.54%),p=0.020]。死亡组所有患者均住院治疗(100.00%),其中 14 例(56.00%)入住 ICU,中位住院时间为 11 天(6-16.5 天)。在有接触暴露的患者中,与无接触暴露史的患者相比,患有血液系统恶性肿瘤和 COVID-19 阳性的患者的生存或死亡风险分别为 2.18(CI:1.90-4.44)倍和 3.10(CI:2.73-4.60)倍(p=0.001)。
综上所述,这些数据支持这样一种共识,即患有血液系统恶性肿瘤的患者因 COVID-19 感染而遭受严重的发病率和死亡率。