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2022 年 12 月以来北京奥密克戎波期间浆细胞异常患者的 COVID-19 特征和结局:国家血液系统疾病临床医学研究中心的一项回顾性研究。

Characteristics and outcomes of COVID-19 in patients with plasma cell dyscrasias during the first Omicron wave in Beijing since December 2022: a retrospective study at a National Clinical Research Center for Hematologic Disease.

机构信息

National Clinical Research Center for Hematologic Disease, Peking University Institute of Hematology, Peking University People's Hospital, Beijing, 100044, China.

Department of Hematology, Fu Xing Hospital, Capital Medical University, Beijing, 100038, China.

出版信息

Ann Hematol. 2023 Oct;102(10):2857-2864. doi: 10.1007/s00277-023-05350-y. Epub 2023 Jul 12.

DOI:10.1007/s00277-023-05350-y
PMID:37436471
Abstract

The wave of coronavirus disease 2019 (COVID-19) with Omicron variant reached its first peak in Beijing, China in December 2022. We delineated characteristics and factors associated with adverse outcome of patients with plasma cell dyscrasias (PCDs) and COVID-19 during the first month of the wave. A total of 104 patients with a median age of 65 years were included in the study, with multiple myeloma (74%, n=77) and primary Immunoglobulin light chain amyloidosis (16.3%, n=17) being the two most common disease. Overall, severe or critical COVID-19 was developed in 18 (17.3%) patients, with a total all-cause mortality rate of 4.8% (n=5). The vaccination coverage was 41% and 48.1%, before and during the upsurge of Omicron, respectively, calling for the improvement of vaccination in PCD patients. Multivariable analysis revealed that age was the only independent risk factors (OR=1.14, 95% CI: 1.06-1.26, p = 0.002) associated with the development of severe or critical disease. Among patients with severe or critical group, low levels of albumin (HR=18.29; 95% CI: 1.82-183.44, p = 0.013) and high levels of lactic dehydrogenase (LDH) (HR=0.08; 95% CI: 0.01-0.65, p = 0.018) were associated with longer time to negative conversion of COVID-19.

摘要

2019 年冠状病毒病(COVID-19)疫情与奥密克戎变异株在北京的第一波高峰于 2022 年 12 月达到顶峰。我们描述了在该波期间发生 COVID-19 的浆细胞异常疾病(PCD)患者的不良结局的特征和相关因素。该研究共纳入 104 例中位年龄为 65 岁的患者,其中多发性骨髓瘤(74%,n=77)和原发性免疫球蛋白轻链淀粉样变性(16.3%,n=17)是两种最常见的疾病。总体而言,18 例(17.3%)患者发生严重或危重症 COVID-19,总全因死亡率为 4.8%(n=5)。疫苗接种率分别为 41%和 48.1%,在奥密克戎浪潮之前和期间,分别呼吁提高 PCD 患者的疫苗接种率。多变量分析显示,年龄是唯一与严重或危重症疾病发展相关的独立危险因素(OR=1.14,95%CI:1.06-1.26,p=0.002)。在严重或危重症组中,低白蛋白水平(HR=18.29;95%CI:1.82-183.44,p=0.013)和高乳酸脱氢酶(LDH)水平(HR=0.08;95%CI:0.01-0.65,p=0.018)与 COVID-19 转阴时间较长相关。

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