Başkol Elik Dilşah, Kaya Şafak, Alkan Sevil, Demirdal Tuna, Sener Alper, Kaya Selçuk, Güzel Tunçcan Özlem, Kayaaslan Bircan, Güner Rahmet, Eser Fatma, Kahraman Hasip, Birengel Serhat, Sarıcaoğlu Elif Mukime, Eroğlu Esma, Çölkesen Fatma, Öztürk Erman, Berk Cam Hande, Mermutluoğlu Çiğdem, Özer Balin Şafak, Sincan Gülden, Altın Nilgün, Sili Uluhan, Suntur Bedia Mutay, Arslan Gülen Tuğba, Deveci Burak, Saba Rabin, İncecik Şaban, Eser Karlıdağ Gülden, Hakko Elif, Akdağ Damla, Erdem Hüseyin Aytaç, Sipahi Hilal, Çicek Candan, Taşbakan Mehmet Sezai, Taşbakan Meltem, Pullukçu Hüsnü, Yamazhan Tansu, Arda Bilgin, Ulusoy Sercan, Sipahi Oguz Resat
Department of Infectious Disease and Clinical Microbiology, Faculty of Medicine, Ege University, Bornova, Izmir, Turkey.
Infectious Disease and Clinical Microbiology, Turgutlu State Hospital, Manisa, Turkey.
Sci Rep. 2024 Mar 3;14(1):5218. doi: 10.1038/s41598-024-55886-w.
This multicentre (22 centres in Turkey) retrospective cohort study aimed to assess the clinical outcomes of patients with neutropenic fever and SARS-CoV-2 positivity. Study period was 15 March 2020-15 August 2021. A total of 170 cases (58 female, aged 59 ± 15.5 years) that fulfilled the inclusion criteria were included in the study. One-month mortality rate (OMM) was 44.8%. The logistic regression analysis showed the following significant variables for the mentioned dependent variables: (i) achieving PCR negativity: receiving a maximum of 5 days of favipiravir (p = 0.005, OR 5.166, 95% CI 1.639-16.280); (ii) need for ICU: receiving glycopeptide therapy at any time during the COVID-19/FEN episode (p = 0.001, OR 6.566, 95% CI 2.137-20.172), the need for mechanical ventilation (p < 0.001, OR 62.042, 95% CI 9.528-404.011); (iii) need for mechanical ventilation: failure to recover from neutropenia (p < 0.001, OR 17.869, 95% CI 3.592-88.907), receiving tocilizumab therapy (p = 0.028, OR 32.227, 95% CI 1.469-707.053), septic shock (p = 0.001, OR 15.4 96% CI 3.164-75.897), and the need for ICU (p < 0.001, OR 91.818, 95% CI 15.360-548.873), (iv) OMM: [mechanical ventilation (p = 0.001, OR 19.041, 95% CI 3.229-112.286) and septic shock (p = 0.010, OR 5.589,95% CI 1.509-20.700)]. Although it includes a relatively limited number of patients, our findings suggest that COVID-19 and FEN are associated with significant mortality and morbidity.
这项多中心（土耳其22个中心）回顾性队列研究旨在评估中性粒细胞减少性发热且SARS-CoV-2呈阳性患者的临床结局。研究期间为2020年3月15日至2021年8月15日。共有170例符合纳入标准的病例（58例女性，年龄59±15.5岁）纳入该研究。1个月死亡率（OMM）为44.8%。逻辑回归分析显示了以下与上述因变量相关的显著变量：（i）实现PCR阴性：最多接受5天法匹拉韦治疗（p = 0.005，OR 5.166，95%CI 1.639 - 16.280）；（ii）需要入住重症监护病房（ICU）：在COVID-19/中性粒细胞减少性发热发作期间的任何时间接受糖肽治疗（p = 0.001，OR 6.566，95%CI 2.137 - 20.172），需要机械通气（p < 0.001，OR 62.042，95%CI 9.528 - 404.011）；（iii）需要机械通气：中性粒细胞减少未恢复（p < 0.001，OR 17.869，95%CI 3.592 - 88.907），接受托珠单抗治疗（p = 0.028，OR 32.227，95%CI 1.469 - 707.053），感染性休克（p = 0.001，OR 15.4，96%CI 3.164 - 75.897），以及需要入住ICU（p < 0.001，OR 91.818，95%CI 15.360 - 548.873）；（iv）1个月死亡率（OMM）：[机械通气（p = 0.001，OR 19.041，95%CI 3.229 - 112.286）和感染性休克（p = 0.010，OR 5.589，95%CI 1.509 - 20.700）]。尽管本研究纳入的患者数量相对有限，但我们的研究结果表明，COVID-19和中性粒细胞减少性发热与显著的死亡率和发病率相关。
