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安道尔公国癌症患者接种疫苗前后的血清流行率研究(COVONCO 研究)。

Seroprevalence study prior and post vaccination in cancer patients in principality of Andorra (COVONCO study).

机构信息

Department of Internal Medicine, Hospital Nostra Senyora de Meritxell, Andorra Andorra Health Services (SAAS), Av. Fiter i Rosell 1-13, AD700, Escaldes-Engordany, Andorra.

University of Nottingham Medical School, Queens Medical Centre, Nottingham, UK.

出版信息

J Cancer Res Clin Oncol. 2023 Jul;149(7):2883-2892. doi: 10.1007/s00432-022-04141-8. Epub 2022 Jul 9.

Abstract

BACKGROUND

COVID-19 serologic response in patients with cancer may be lower than in the general population and may be influenced by the type of tumor or anticancer treatment. This study aims to analyze serological response prior and after vaccination of COVID-19 within the oncological population in Andorra. We set out to identify risk factors for a higher or lower serological response.

PATIENTS AND METHODS

Observational, unicentric, prospective cohort study of oncologic patients in Andorra. We calculated the seroprevalence of antibodies against SARS-CoV-2 (May 2020-June 2021) and analyzed the main demographic, oncologic features and factors associated with being seropositive.

RESULTS

A total of 373 patients were analyzed, mainly with solid tumours (n = 334, 89.5%). At baseline, seroprevalence was 13%, increasing during follow-up to 19%; lower seroprevalence was observed in patients with hematologic malignancies (2.6% vs 14.2%; p = 0.041) and patients receiving biological therapies (0% vs 15%, p = 0.005). In the overall seroprevalence analysis, women (23% vs 11.9%; p = 0.006) and tumour-free patients (p = 0.034) showed higher seroprevalence. The multivariable analysis showed that odds of being seropositive were higher among women (OR: 2.44, 95% CI 1.28-4.64), and patients who underwent surgery (OR: 3.35, 95% CI 1.10-10.20). About 80% of the cohort received at least one dose of COVID-19 vaccination, showing a higher seroprevalence of patients who received ChAdOx1-S than those who received BNT162b2 (24.4% vs 6.4%: p = 0.001).

CONCLUSION

The seroprevalence of antibodies against SARS-COV-2 in oncologic patients in Andorra was higher among females and patients who received hormonal therapy and surgery while patients with hematologic malignancies and biologic therapies showed lower seropositivity without finding differences in the type of tumour or anticancer treatment.

摘要

背景

癌症患者的 COVID-19 血清学反应可能低于一般人群,并且可能受到肿瘤类型或抗癌治疗的影响。本研究旨在分析安道尔肿瘤患者 COVID-19 疫苗接种前后的血清学反应,并确定更高或更低血清学反应的风险因素。

患者和方法

这是一项安道尔肿瘤患者的观察性、单中心、前瞻性队列研究。我们计算了针对 SARS-CoV-2 的抗体血清阳性率(2020 年 5 月至 2021 年 6 月),并分析了主要的人口统计学、肿瘤特征和与血清阳性相关的因素。

结果

共分析了 373 例患者,主要为实体瘤(n=334,89.5%)。基线时,血清阳性率为 13%,随访期间增加到 19%;血液恶性肿瘤患者(2.6% vs 14.2%;p=0.041)和接受生物治疗的患者(0% vs 15%;p=0.005)的血清阳性率较低。在总体血清阳性率分析中,女性(23% vs 11.9%;p=0.006)和无肿瘤患者(p=0.034)的血清阳性率更高。多变量分析显示,女性(比值比:2.44,95%置信区间 1.28-4.64)和接受手术的患者(比值比:3.35,95%置信区间 1.10-10.20)的血清阳性率更高。大约 80%的患者接受了至少一剂 COVID-19 疫苗接种,接受 ChAdOx1-S 疫苗接种的患者血清阳性率高于接受 BNT162b2 疫苗接种的患者(24.4% vs 6.4%:p=0.001)。

结论

安道尔肿瘤患者的 SARS-CoV-2 抗体血清阳性率在女性和接受激素治疗和手术的患者中较高,而血液恶性肿瘤和生物治疗患者的血清阳性率较低,但未发现肿瘤类型或抗癌治疗的差异。

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