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COVID-19 癌症患者的临床和炎症标志物特征:土耳其伊斯坦布尔多中心癌症患者数据(2020-2022 年)。

Clinical and inflammation marker features of cancer patients with COVID-19: data of Istanbul, Turkey multicenter cancer patients (2020-2022).

机构信息

Division of Medical Oncology, Department of Internal Medicine, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul, Turkey.

Department of Infectious Diseases and Clinical Microbiology, Haseki Training and Research Hospital, Istanbul, Turkey.

出版信息

Curr Med Res Opin. 2023 Jul;39(7):987-996. doi: 10.1080/03007995.2023.2223917. Epub 2023 Jun 23.

Abstract

OBJECTIVE

We aimed to identify a rapid, accurate, and accessible biomarker in the early stages of COVID-19 that can determine the prognosis of the disease in cancer patients.

METHODS

A total number of 241 patients with solid cancers who had a COVID-19 diagnosis between March 2020 and February 2022 were included in the study. Factors and ten different markers of inflammation were analyzed by year of diagnosis of COVID-19 and grouped by severity of infection.

RESULTS

Hospitalization, referral to the intensive care unit (ICU), mechanical ventilation, and death were more frequent in 2020 than in 2021 and 2022 (mortality rates, respectively, were 18.8%, 3.8%, and 2.5%). Bilateral lung involvement and chronic lung disease were independent risk factors for severe disease in 2020. In 2021-2022, only bilateral lung involvement was found as an independent risk factor for severe disease. The neutrophil-to-lymphocyte platelet ratio (NLPR) with the highest area under the curve (AUC) value in 2020 had a sensitivity of 71.4% and specificity of 73.3% in detecting severe disease (cut-off > 0.0241, Area Under the Curve (AUC) = 0.842,  <.001). In 2021-2022, the sensitivity of the C-reactive protein-to-lymphocyte ratio (CRP/L) with the highest AUC value was 70.0%, and the specificity was 73.3% (cut-off > 36.7, AUC = 0.829,  = .001).

CONCLUSIONS

This is the first study to investigate the distribution and characteristics of cancer patients, with a focus on the years of their COVID-19 diagnosis. Based on the data from our study, bilateral lung involvement is an independent factor for severe disease, and the CRP/L inflammation index appears to be the most reliable prognostic marker.

摘要

目的

我们旨在确定 COVID-19 早期的一种快速、准确和易于获取的生物标志物,以确定癌症患者疾病的预后。

方法

本研究纳入了 2020 年 3 月至 2022 年 2 月期间被诊断患有实体癌且 COVID-19 的 241 名患者。通过 COVID-19 的诊断年份分析了炎症的因素和十种不同的标志物,并按感染严重程度进行分组。

结果

2020 年住院、转入重症监护病房(ICU)、机械通气和死亡的频率高于 2021 年和 2022 年(死亡率分别为 18.8%、3.8%和 2.5%)。双侧肺部受累和慢性肺部疾病是 2020 年重症疾病的独立危险因素。在 2021-2022 年,只有双侧肺部受累被发现是重症疾病的独立危险因素。在 2020 年,中性粒细胞与淋巴细胞血小板比(NLPR)的曲线下面积(AUC)值最高,其对重症疾病的检测灵敏度为 71.4%,特异性为 73.3%(截断值>0.0241,AUC=0.842,<.001)。在 2021-2022 年,AUC 值最高的 C 反应蛋白与淋巴细胞比值(CRP/L)的灵敏度为 70.0%,特异性为 73.3%(截断值>36.7,AUC=0.829,<.001)。

结论

这是第一项研究癌症患者分布和特征的研究,重点是他们 COVID-19 诊断的年份。基于我们研究的数据,双侧肺部受累是重症疾病的独立因素,CRP/L 炎症指数似乎是最可靠的预后标志物。

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