Qi Feiyang, Bao Mei, Gao Hanlin, Zhang Xiaoshuai, Zhao Shasha, Wang Chenglei, Li Wenwen, Jiang Qian
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, No. 11 Xizhimen South St, Beijing, 100044, China.
Peking University People's Hospital, Qingdao, China.
Ann Hematol. 2023 Oct;102(10):2707-2716. doi: 10.1007/s00277-023-05413-0. Epub 2023 Aug 14.
To explore the prevalence and severity of COVID-19 and the mental health during the Omicron pandemic in patients with chronic myeloid leukemia (CML), a cross-sectional survey from 2609 respondents with CML was performed. A total of 1725 (66%) reported that they had COVID-19 during this period. Among them, 1621 (94%) were mild; 97 (6%), moderate; 7 (0.4%), severe; and 0, critical or death. Four hundred three (15%), 199 (8%), and 532 (20%) had moderate to severe depression, anxiety, and distress, respectively. Eight hundred ninety (34%), 667 (26%), and 573 (22%), avoidance, intrusion, and hyper-arousal, respectively. In multivariate analyses, longer TKI-therapy duration was significantly associated with a lower prevalence of COVID-19 (odds ratio [OR] = 0.98; 95% confidence interval [CI], 0.95, 0.99; p = 0.043); however, living in urban areas (OR = 1.6 [1.3, 2.0]; p < 0.001) and having family members with COVID-19 (OR = 18.6 [15.1, 22.8]; p < 0.001), a higher prevalence of COVID-19. Increasing age (OR = 1.2 [1.1, 1.4]; p = 0.009), comorbidity(ies) (OR = 1.7 [1.1, 2.7]; p = 0.010), and multi-TKI-resistant patients receiving 3rd-generation TKIs or investigational agents (OR = 2.2 [1.2, 4.2]; p = 0.010) were significantly associated with moderate or severe COVID-19. Female, comorbidity(ies), unvaccinated, and moderate or severe COVID-19 were significantly associated with almost all adverse mental health consequences; increasing age or forced TKI dose reduction because of various restriction during the pandemic, moderate to severe distress, avoidance, or intrusion; however, mild COVID-19, none or mild anxiety, distress, avoidance, or intrusion. In conclusion, shorter TKI-therapy duration, increasing age, comorbidity(ies), or multi-TKI-resistant patients receiving 3rd-generation TKIs or investigational agents had a higher prevalence of COVID-19 or higher risk of moderate or severe disease in patients with CML; increasing age, female, comorbidity(ies), forced TKI dose reduction due to the pandemic, moderate or severe COVID-19, unvaccinated, a higher likelihood of worse mental health.
为探究慢性髓性白血病（CML）患者在奥密克戎大流行期间的新冠病毒病（COVID-19）患病率、严重程度及心理健康状况，对2609名CML受访者进行了一项横断面调查。共有1725人（66%）报告在此期间感染了COVID-19。其中，1621人（94%）为轻症；97人（6%）为中症；7人（0.4%）为重症；无危重症或死亡病例。分别有403人（15%）、199人（8%）和532人（20%）患有中度至重度抑郁、焦虑和心理困扰。分别有890人（34%）、667人（26%）和573人（22%）存在回避、侵入和过度唤醒症状。在多变量分析中，较长的酪氨酸激酶抑制剂（TKI）治疗时间与较低的COVID-19患病率显著相关（比值比[OR]=0.98；95%置信区间[CI]，0.95，0.99；p=0.043）；然而，居住在城市地区（OR=1.6[1.3，2.0]；p<0.001）以及有家庭成员感染COVID-19（OR=18.6[15.1，22.8]；p<0.001），则COVID-19患病率较高。年龄增加（OR=1.2[1.1，1.4]；p=0.009）、合并症（OR=1.7[1.1，2.7]；p=0.010）以及接受第三代TKI或研究性药物的多TKI耐药患者（OR=2.2[1.2，4.2]；p=0.010）与中度或重度COVID-19显著相关。女性、合并症、未接种疫苗以及中度或重度COVID-19与几乎所有不良心理健康后果显著相关；年龄增加或因疫情期间各种限制导致TKI剂量被迫减少与中度至重度心理困扰、回避或侵入相关；然而，轻症COVID-19与无或轻度焦虑、心理困扰、回避或侵入相关。总之，较短的TKI治疗时间、年龄增加、合并症或接受第三代TKI或研究性药物的多TKI耐药患者在CML患者中COVID-19患病率较高或患中度或重度疾病的风险较高；年龄增加、女性、合并症、因疫情导致TKI剂量被迫减少、中度或重度COVID-19、未接种疫苗，心理健康状况较差的可能性更高。
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