2019冠状病毒病结局、患者疫苗接种状况及奥密克戎毒株流行期间与癌症相关的延误：TERAVOLT分析简要报告
Coronavirus Disease 2019 Outcomes, Patient Vaccination Status, and Cancer-Related Delays During the Omicron Wave: A Brief Report From the TERAVOLT Analysis.
作者信息
Bestvina Christine M, Whisenant Jennifer G, Torri Valter, Cortellini Alessio, Wakelee Heather, Peters Solange, Roca Elisa, De Toma Alessandro, Hirsch Fred R, Mamdani Hirva, Halmos Balazs, Arrieta Oscar, Metivier Anne-Cecile, Fidler Mary J, Rogado Jacobo, Presley Carolyn J, Mascaux Celine, Genova Carlo, Blaquier Juan Bautista, Addeo Alfredo, Finocchiaro Giovanna, Khan Hina, Mazieres Julien, Morgillo Floriana, Bar Jair, Aujayeb Avinash, Mountzios Giannis, Scotti Vieri, Grosso Federica, Geraedts Erica, Zhumagaliyeva Ardak N, Horn Leora, Garassino Marina Chiara, Baena Javier
机构信息
Department of Medicine, University of Chicago Comprehensive Cancer Center, University of Chicago, Chicago, Illinois.
Vanderbilt University Medical Center, Nashville, Tennessee.
出版信息
JTO Clin Res Rep. 2022 Aug;3(8):100335. doi: 10.1016/j.jtocrr.2022.100335. Epub 2022 May 20.
INTRODUCTION
The Thoracic Centers International coronavirus disease 2019 (COVID-19) Collaboration (TERAVOLT) registry found approximately 30% mortality in patients with thoracic malignancies during the initial COVID-19 surges. Data from South Africa suggested a decrease in severity and mortality with the Omicron wave. Our objective was to assess mortality of patients with thoracic malignancies with the Omicron-predominant wave and evaluate efficacy of vaccination.
METHODS
A prospective, multicenter observational study was conducted. A total of 28 institutions contributed data from January 14, 2022, to February 4, 2022. Inclusion criteria were any thoracic cancer and a COVID-19 diagnosis on or after November 1, 2021. End points included mortality, hospitalization, symptomatic COVID-19 infection, asymptomatic COVID-19 infection, and delay in cancer therapy. Analysis was done through contingency tables and a multivariable logistic model.
RESULTS
We enrolled a total of 346 patients. Median age was 65 years, 52.3% were female, 74.2% were current or former smokers, 86% had NSCLC, 72% had stage IV at time of COVID-19 diagnosis, and 66% were receiving cancer therapy. Variant was unknown for 70%; for those known, Omicron represented 82%. Overall mortality was 3.2%. Using multivariate analysis, COVID-19 vaccination with booster compared with no vaccination had a protective effect on hospitalization or death (OR = 0.30, confidence interval: 0.15-0.57, = 0.0003), whereas vaccination without booster did not (OR = 0.64, confidence interval: 0.33-1.24, = 0.1864). Cancer care was delayed in 56.4% of the patients.
CONCLUSIONS
TERAVOLT found reduced patient mortality with the most recent COVID-19 surge. COVID-19 vaccination with booster improved outcomes of hospitalization or death. Delays in cancer therapy remain an issue, which has the potential to worsen cancer-related mortality.
引言
国际胸科中心2019冠状病毒病（COVID-19）协作研究（TERAVOLT）登记处发现，在最初的COVID-19疫情高峰期间，胸段恶性肿瘤患者的死亡率约为30%。来自南非的数据表明，随着奥密克戎毒株浪潮的出现，疾病严重程度和死亡率有所下降。我们的目的是评估以奥密克戎毒株为主的疫情期间胸段恶性肿瘤患者的死亡率，并评估疫苗接种的效果。
方法
开展了一项前瞻性多中心观察性研究。共有28家机构提供了2022年1月14日至2022年2月4日的数据。纳入标准为任何胸段癌症且在2021年11月1日或之后确诊COVID-19。终点包括死亡率、住院情况、有症状的COVID-19感染、无症状的COVID-19感染以及癌症治疗延迟情况。通过列联表和多变量逻辑模型进行分析。
结果
我们共纳入346例患者。中位年龄为65岁，52.3%为女性，74.2%为当前或既往吸烟者，86%患有非小细胞肺癌，72%在COVID-19确诊时处于IV期，66%正在接受癌症治疗。70%的患者感染的毒株未知；在已知毒株的患者中，奥密克戎毒株占82%。总体死亡率为3.2%。采用多变量分析，与未接种疫苗相比，接种加强针的COVID-19疫苗对住院或死亡具有保护作用（比值比=0.30，置信区间：0.15 - 0.57，P = 0.0003），而未接种加强针的疫苗则没有（比值比=0.64，置信区间：0.33 - 1.24，P = 0.1864）。56.4%的患者癌症治疗延迟。
结论
TERAVOLT研究发现，在最近一次COVID-19疫情高峰期间患者死亡率有所降低。接种加强针的COVID-19疫苗改善了住院或死亡结局。癌症治疗延迟仍是一个问题，这有可能使癌症相关死亡率恶化。
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