Department of Medical Oncology, National Cancer Institute, New Delhi, India.
Department of Medical Oncology, BL Kapur Hospital, New Delhi, India.
Indian J Med Res. 2022 May-Jun;155(5&6):546-553. doi: 10.4103/ijmr.ijmr_1703_21.
BACKGROUND & OBJECTIVES: High mortality has been observed in the cancer population affected with COVID-19 during this pandemic. We undertook this study to determine the characteristics and outcomes of cancer patients with COVID-19 and assessed the factors predicting outcome.
Patients of all age groups with a proven history of malignancy and a recent diagnosis of SARS-CoV-2 infection based on nasal/nasopharyngeal reverse transcriptase (RT)-PCR tests were included. Demographic, clinical and laboratory variables were compared between survivors and non-survivors groups, with respect to observed mortality.
Between May 11 and August 10, 2020, 134 patients were included from the three centres and observed mortality was 17.1 per cent. The median age was 53 yr (interquartile range 39-61 yr) and thirty four patients (25%) were asymptomatic. Solid tumours accounted for 69.1 per cent and breast cancer was the most common tumour type (20%). One hundred and five patients (70.5%) had received chemotherapy within the past four weeks and 25 patients (19.3%) had neutropenia at presentation. On multivariate analysis, age [odds ratio (OR) 7.99 (95% confidence interval [CI] 1.18-54.00); P=0.033], haemoglobin [OR 6.28 (95% CI 1.07-37.04); P=0.042] neutrophil-lymphocyte ratio [OR 12.02 (95% CI 2.08-69.51); P=0.005] and baseline serum albumin [OR 18.52 (95% CI 2.80-122.27); P=0.002], were associated with higher mortality. Recent chemotherapy, haematological tumours type and baseline neutropenia did not affect the outcome.
INTERPRETATION & CONCLUSIONS: Higher mortality in moderate and severe infections was associated with baseline organ dysfunction and elderly age. Significant proportion of patients were asymptomatic and might remain undetected.
在此次大流行期间,患有 COVID-19 的癌症患者死亡率较高。本研究旨在确定患有 COVID-19 的癌症患者的特征和结局,并评估预测结局的因素。
纳入所有年龄段的、有明确恶性肿瘤病史且近期基于鼻咽/鼻咽逆转录酶(RT)-PCR 检测确诊 SARS-CoV-2 感染的患者。比较了幸存者和非幸存者组的人口统计学、临床和实验室变量,观察死亡率。
2020 年 5 月 11 日至 8 月 10 日,从三个中心纳入了 134 例患者,观察死亡率为 17.1%。中位年龄为 53 岁(四分位距 39-61 岁),34 例患者(25%)无症状。实体瘤占 69.1%,乳腺癌是最常见的肿瘤类型(20%)。105 例患者(70.5%)在过去四周内接受过化疗,25 例患者(19.3%)在就诊时中性粒细胞减少。多变量分析显示,年龄[比值比(OR)7.99(95%置信区间 [CI] 1.18-54.00);P=0.033]、血红蛋白[OR 6.28(95% CI 1.07-37.04);P=0.042]、中性粒细胞与淋巴细胞比值[OR 12.02(95% CI 2.08-69.51);P=0.005]和基线血清白蛋白[OR 18.52(95% CI 2.80-122.27);P=0.002]与更高的死亡率相关。近期化疗、血液系统肿瘤类型和基线中性粒细胞减少并不影响结局。
中度和重度感染的高死亡率与基线器官功能障碍和老年有关。相当一部分患者无症状,可能未被发现。