接种 SARS-CoV-2 疫苗可预防癌症患者因 COVID19 而出现的发病、死亡和后遗症。
Vaccination against SARS-CoV-2 protects from morbidity, mortality and sequelae from COVID19 in patients with cancer.
机构信息
Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.
Department of Translational Medicine, Unit of Medical Statistics, University of Piemonte Orientale, Novara, Italy.
出版信息
Eur J Cancer. 2022 Aug;171:64-74. doi: 10.1016/j.ejca.2022.04.036. Epub 2022 May 23.
BACKGROUND
Although SARS-CoV-2 vaccines immunogenicity in patients with cancer has been investigated, whether they can significantly improve the severity of COVID-19 in this specific population is undefined.
METHODS
Capitalizing on OnCovid (NCT04393974) registry data we reported COVID-19 mortality and proxies of COVID-19 morbidity, including post-COVID-19 outcomes, according to the vaccination status of the included patients.
RESULTS
2090 eligible patients diagnosed with COVID-19 between 02/2020 and 11/2021 were included, of whom 1930 (92.3%) unvaccinated, 91 (4.4%) fully vaccinated and 69 (3.3%) partially vaccinated. With the exception of a higher prevalence of patients from the UK (p = 0.0003) and receiving systemic anticancer therapy at COVID-19 diagnosis (p = 0.0082) among fully vaccinated patients, no demographics/oncological features were associated with vaccination status. The 14-days case fatality rate (CFR) (5.5% vs 20.7%, p = 0.0004) and the 28-days CFR (13.2% vs 27.4%, p = 0.0028) demonstrated a significant improvement for fully vaccinated patients in comparison with unvaccinated patients. The receipt of prior full vaccination was also associated with reduced symptomatic COVID-19 (79.1% vs 88.5%, p = 0.0070), need of COVID-19 oriented therapy (34.9% vs 63.2%, p < 0.0001), complications from COVID-19 (28.6% vs 39.4%, p = 0.0379), hospitalizations due to COVID-19 (42.2% vs 52.5%, p = 0.0007) and oxygen therapy requirement (35.7% vs 52%, p = 0.0036). Following Inverse Probability Treatment Weighting (IPTW) procedure no statistically significant difference according to the vaccination status was confirmed; however, all COVID-19 related outcomes were concordantly in favour of full vaccination. Among the 1228 (58.8%) patients who underwent a formal reassessment at participating centres after COVID-19 resolution, fully vaccinated patients experienced less sequelae than unvaccinated patients (6.7% vs 17.2%, p = 0.0320).
CONCLUSIONS
This analysis provides initial evidence in support of the beneficial effect of SARS-CoV-2 vaccines against morbidity and mortality from COVID-19 in patients with cancer.
背景
尽管已经研究了 SARS-CoV-2 疫苗在癌症患者中的免疫原性，但它们是否能显著改善这一特定人群 COVID-19 的严重程度仍未确定。
方法
利用 OnCovid（NCT04393974）登记数据，我们根据纳入患者的疫苗接种状况，报告了 COVID-19 的死亡率和 COVID-19 发病率的替代指标，包括 COVID-19 后的结局。
结果
2020 年 2 月至 2021 年 11 月期间共纳入了 2090 名确诊 COVID-19 的患者，其中 1930 名（92.3%）未接种疫苗，91 名（4.4%）完全接种疫苗，69 名（3.3%）部分接种疫苗。除了完全接种疫苗的患者中来自英国的患者比例较高（p=0.0003）和 COVID-19 诊断时接受全身抗癌治疗的患者比例较高（p=0.0082）外，疫苗接种状况与其他人口统计学/肿瘤学特征无关。14 天病死率（CFR）（5.5%比 20.7%，p=0.0004）和 28 天 CFR（13.2%比 27.4%，p=0.0028）显示，与未接种疫苗的患者相比，完全接种疫苗的患者有显著改善。先前接受过完全接种疫苗也与症状性 COVID-19 减少（79.1%比 88.5%，p=0.0070）、需要 COVID-19 定向治疗（34.9%比 63.2%，p<0.0001）、COVID-19 并发症（28.6%比 39.4%，p=0.0379）、COVID-19 住院（42.2%比 52.5%，p=0.0007）和氧疗需求（35.7%比 52%，p=0.0036）有关。在进行逆概率治疗加权（Inverse Probability Treatment Weighting，IPTW）程序后，没有发现疫苗接种状况存在统计学显著差异；然而，所有 COVID-19 相关结局均一致有利于完全接种疫苗。在 1228 名（58.8%）接受 COVID-19 缓解后在参与中心进行正式重新评估的患者中，完全接种疫苗的患者比未接种疫苗的患者经历的后遗症更少（6.7%比 17.2%，p=0.0320）。
结论
这项分析初步提供了证据，支持 SARS-CoV-2 疫苗在癌症患者中预防 COVID-19 发病率和死亡率的有益作用。
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