Mina Alain, Galvez Carlos, Karmali Reem, Mulcahy Mary, Mi Xinlei, Kocherginsky Masha, Gurley Michael J, Katam Neelima, Gradishar William, Altman Jessica K, Ison Michael G, Tsarwhas Dean, George Christopher, Winter Jane N, Gordon Leo I, Wehbe Firas H, Platanias Leonidas C
Division of Blood and Marrow Transplantation and Cellular Therapies, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611, USA.
Cancers (Basel). 2022 Apr 28;14(9):2209. doi: 10.3390/cancers14092209.
Patients with a history of malignancy have been shown to be at an increased risk of COVID-19-related morbidity and mortality. Poorer clinical outcomes in that patient population are likely due to the underlying systemic illness, comorbidities, and the cytotoxic and immunosuppressive anti-tumor treatments they are subjected to. We identified 416 cancer patients with SARS-CoV-2 infection being managed for their malignancy at Northwestern Medicine in Chicago, Illinois, between March and July of 2020. Seventy-five (18.0%) patients died due to COVID-related complications. Older age (>60), male gender, and current treatment with immunotherapy were associated with shorter overall survival. Laboratory findings showed that higher platelet counts, ALC, and hemoglobin were protective against critical illness and death from COVID-19. Conversely, elevated inflammatory markers such as ferritin, d-dimer, procalcitonin, CRP, and LDH led to worse clinical outcomes. Our findings suggest that a thorough clinical and laboratory assessment of infected patients with cancer might help identify a more vulnerable population and implement more aggressive proactive strategies.
有恶性肿瘤病史的患者已被证明感染新型冠状病毒肺炎相关发病和死亡风险增加。该患者群体较差的临床结局可能归因于潜在的全身性疾病、合并症以及他们所接受的细胞毒性和免疫抑制抗肿瘤治疗。我们确定了2020年3月至7月期间在伊利诺伊州芝加哥西北大学医学中心接受恶性肿瘤治疗的416例感染新型严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的癌症患者。75例（18.0%）患者死于新型冠状病毒肺炎相关并发症。年龄较大（>60岁）、男性以及目前接受免疫治疗与较短的总生存期相关。实验室检查结果显示，较高的血小板计数、淋巴细胞绝对值和血红蛋白对新型冠状病毒肺炎危重症和死亡具有保护作用。相反，铁蛋白、D-二聚体、降钙素原、C反应蛋白和乳酸脱氢酶等炎症标志物升高导致临床结局更差。我们的研究结果表明，对感染癌症的患者进行全面的临床和实验室评估可能有助于识别更脆弱的人群并实施更积极主动的策略。
