Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Department of Otolaryngology-Head and Neck Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Oral Oncol. 2023 Apr;139:106353. doi: 10.1016/j.oraloncology.2023.106353. Epub 2023 Feb 23.
Laryngeal and hypopharyngeal cancers treated with total laryngectomy (TL) may provide a unique avenue for COVID-19 to infect cancer patients. The objective of this investigation was to identify incidence of COVID-19 infection and potential complications in TL patients.
Data was extracted from TriNetX COVID-19 research network from from 2019 to 2021 and ICD-10 codes were utilized to query for laryngeal or hypopharyngeal cancer, and outcomes of interest. Cohorts were propensity score-matched based on demographics and co-morbidities.
A query of active patients in TriNetX from January 1, 2019 to December 31, 2021 identified 36,414 patients with laryngeal or hypopharyngeal cancer out of the 50,474,648 active patients in the database. The overall COVID-19 incidence in the non-laryngeal or hypopharyngeal cancer population was 10.8% compared to 18.8% (p < 0.001) in the laryngeal and hypopharyngeal cancer group. Those who underwent TL had a statistically significant increased incidence of acquiring COVID-19 (24.0%) when compared to those without TL (17.7%) (p < 0.001). TL patients with COVID-19 had a higher risk of developing pneumonia RR (risk ratio) 1.80 (1.43, 2.26), death 1.74 (1.41, 2.14), ARDS 2.42 (1.16, 5.05), sepsis 1.77 (1.37, 2.29), shock 2.81 (1.88, 4.18), respiratory failure 2.34 (1.90, 2.88), and malnutrition 2.46 (2.01, 3.01) when matched with those COVID-19 positive cancer patients without TL.
Laryngeal and hypopharyngeal cancer patients had a higher rate of acquiring COVID-19 than patients without these cancers. TL patients have a higher rate of COVID-19 compared to those without TL and may be at a higher risk for sequalae of COVID-19.
接受全喉切除术（TL）治疗的喉和下咽癌患者可能为 COVID-19 感染癌症患者提供了一个独特的途径。本研究的目的是确定 TL 患者 COVID-19 感染和潜在并发症的发生率。
从 2019 年至 2021 年，从 TriNetX COVID-19 研究网络中提取数据，并利用 ICD-10 代码查询喉或下咽癌和感兴趣的结果。根据人口统计学和合并症对队列进行倾向评分匹配。
对 TriNetX 中 2019 年 1 月 1 日至 2021 年 12 月 31 日期间的活跃患者进行查询，在数据库中的 50,474,648 名活跃患者中，发现 36,414 名患有喉或下咽癌的患者。非喉或下咽癌患者群中 COVID-19 的总体发病率为 10.8%，而喉和下咽癌组为 18.8%（p<0.001）。与未行 TL 的患者相比，行 TL 的患者感染 COVID-19 的发生率具有统计学意义的增加（24.0%）（p<0.001）。患有 COVID-19 的 TL 患者发生肺炎的风险更高 RR（风险比）1.80（1.43，2.26），死亡风险 1.74（1.41，2.14），ARDS 2.42（1.16，5.05），败血症 1.77（1.37，2.29），休克 2.81（1.88，4.18），呼吸衰竭 2.34（1.90，2.88），营养不良 2.46（2.01，3.01），与 COVID-19 阳性但未行 TL 的癌症患者相匹配。
患有喉和下咽癌的患者比未患有这些癌症的患者感染 COVID-19 的几率更高。TL 患者感染 COVID-19 的几率高于未行 TL 的患者，并且可能有更高的 COVID-19 后遗症风险。
