Johansson Anna L V, Skog Anna, Johannesen Tom Børge, Myklebust Tor Åge, Skovlund Charlotte Wessel, Mørch Lina Steinrud, Friis Søren, Gamborg Mads, Kristiansen Marnar Fríðheim, Pettersson David, Ólafsdóttir Elínborg J, Birgisson Helgi, Palsson Runolfur, Eythorsson Elias, Irenaeus Sandra, Lambe Mats, Ursin Giske
Cancer Registry of Norway, P.O. Box 5313 Majorstuen, Oslo N-0304, Norway.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, P.O. Box 281, Stockholm SE-17177, Sweden.
Lancet Reg Health Eur. 2023 Jul 10;31:100680. doi: 10.1016/j.lanepe.2023.100680. eCollection 2023 Aug.
In a population-based setting, we investigated the risks of testing positive for SARS-CoV-2 and developing severe COVID-19 outcomes among cancer patients compared with the general population.
In nationwide cohorts, we identified all individuals in Norway, Denmark and Iceland who tested positive for SARS-CoV-2 or had a severe COVID-19 outcome (hospitalisation, intensive care, and death) from March until December 2020, using data from national health registries. We estimated standardised incidence ratios (SIRs) with 95% confidence intervals (CIs) comparing cancer patients with the general population.
During the first wave of the pandemic, cancer patients in Norway and Denmark had higher risks of testing SARS-CoV-2 positive compared to the general population. Throughout 2020, recently treated cancer patients were more likely to test SARS-CoV-2 positive. In Iceland, cancer patients experienced no increased risk of testing positive. The risk of COVID-19-related hospitalisation was higher among cancer patients diagnosed within one year of hospitalisation (Norway: SIR = 2.43, 95% CI 1.89-3.09; Denmark: 2.23, 1.96-2.54) and within five years (Norway: 1.58, 1.35-1.83; Denmark: 1.54, 1.42-1.66). Risks were higher in recently treated cancer patients and in those diagnosed with haematologic malignancies, colorectal or lung cancer. Risks of COVID-19-related intensive care and death were higher among cancer patients.
Cancer patients were at increased risk of testing positive for SARS-CoV-2 during the first pandemic wave when testing availability was limited, while relative risks of severe COVID-19 outcomes remained increased in cancer patients throughout 2020. Recent cancer treatment and haematologic malignancy were the strongest risk factors.
Nordic Cancer Union.
在基于人群的研究中，我们调查了与普通人群相比，癌症患者中新型冠状病毒2（SARS-CoV-2）检测呈阳性以及出现严重冠状病毒病2019（COVID-19）结局的风险。
在全国性队列研究中，我们利用国家卫生登记处的数据，确定了2020年3月至12月期间挪威、丹麦和冰岛所有新型冠状病毒2检测呈阳性或出现严重COVID-19结局（住院、重症监护和死亡）的个体。我们估计了标准化发病率比（SIRs）及其95%置信区间（CIs），以比较癌症患者与普通人群。
在疫情的第一波期间，挪威和丹麦的癌症患者新型冠状病毒2检测呈阳性的风险高于普通人群。在2020年全年，近期接受治疗的癌症患者更有可能新型冠状病毒2检测呈阳性。在冰岛，癌症患者检测呈阳性的风险没有增加。在住院后一年内被诊断出的癌症患者中，COVID-19相关住院风险更高（挪威：SIR = 2.43，95% CI 1.89 - 3.09；丹麦：2.23，1.96 - 2.54），在五年内被诊断出的患者中也是如此（挪威：1.58，1.35 - 1.83；丹麦：1.54，1.42 - 1.66）。近期接受治疗的癌症患者以及被诊断患有血液系统恶性肿瘤、结直肠癌或肺癌的患者风险更高。癌症患者中COVID-19相关重症监护和死亡风险更高。
在疫情第一波期间，当检测机会有限时，癌症患者新型冠状病毒2检测呈阳性的风险增加，而在2020年全年，癌症患者出现严重COVID-19结局的相对风险仍然增加。近期癌症治疗和血液系统恶性肿瘤是最强的风险因素。
北欧癌症联盟。
