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COVID-19 感染血液病患者:中国奥密克戎疫情中一项单中心调查。

COVID-19 infection in patients with haematological malignancies: A single-centre survey in the latest Omicron wave in China.

机构信息

National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Peking University, Beijing, China.

Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.

出版信息

Br J Haematol. 2023 Jul;202(1):31-39. doi: 10.1111/bjh.18823. Epub 2023 Apr 24.

Abstract

As the COVID-19 variant Omicron surge in Beijing, China, a better understanding of risk factors for adverse outcomes may improve clinical management in patients with haematological malignancies (HM) diagnosed with COVID-19. The study sample includes 412 cases, mainly represented by acute leukaemia, chronic myeloid leukaemia (CML), plasma cell disorders and lymphoma and chronic lymphocytic leukaemia. COVID-19 pneumonia was observed in 10.4% (43/412) of patients, and severe/critical illness was observed in 5.3% (22/412). Among the 86 cases with advanced malignancies, 17.6% (12/86) of patients developed severe/critical COVID-19, which was significantly higher than reported in patients with stable malignancies (9/326, 2.70%, p < 0.001). Similarly, the advanced malignancy cohort had a higher mortality rate (9/86, 10.5% vs. 0/326, 0%, p < 0.001) and a poor 30-day overall survival (OS) compared with the stable malignancy cohort (74.2% vs. 100.0%, p < 0.0001). Overall, nine patients (2.2%) died. The primary cause of death was progressive HM in four patients and a combination of both COVID-19 and HM in five patients. In the multivariable analysis, over 65 years of age, comorbidities and advanced malignancy were correlated with severe/critical COVID-19 in HM patients. This study sheds light on the poor outcomes among COVID-19 HM patients with the leading cause of advanced malignancy.

摘要

随着中国北京 COVID-19 变异株奥密克戎的激增,更好地了解不良结局的危险因素可能会改善确诊 COVID-19 的血液恶性肿瘤 (HM) 患者的临床管理。研究样本包括 412 例病例,主要由急性白血病、慢性髓性白血病 (CML)、浆细胞疾病和淋巴瘤以及慢性淋巴细胞白血病组成。412 例患者中观察到 COVID-19 肺炎 10.4%(43/412),重症/危重症 5.3%(22/412)。在 86 例晚期恶性肿瘤患者中,17.6%(12/86)的患者发生严重/危重症 COVID-19,明显高于稳定期恶性肿瘤患者(9/326,2.70%,p<0.001)。同样,晚期恶性肿瘤组的死亡率(9/86,10.5%比 0/326,0%,p<0.001)和较差的 30 天总生存率(OS)也高于稳定期恶性肿瘤组(74.2%比 100.0%,p<0.0001)。总体而言,有 9 例患者(2.2%)死亡。死亡的主要原因是 4 例患者 HM 进展,5 例患者 COVID-19 和 HM 并存。多变量分析显示,65 岁以上、合并症和晚期恶性肿瘤与 HM 患者的严重/危重症 COVID-19 相关。本研究揭示了 COVID-19 HM 患者中晚期恶性肿瘤为主的不良结局。

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