急性髓系白血病（AML）和骨髓增生异常综合征（MDS）中的新型冠状病毒肺炎（COVID-19）：一项倾向匹配分析（2020 - 2021年）
COVID-19 in acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS): a propensity matched analysis (2020-2021).
作者信息
Sivasubramanian Barath Prashanth, Joshi Shashvat, Ravikumar Diviya Bharathi, Babu Sonia, Sripathi Shanthi Reddy, Javvaji Avinash, Jain Priyanshu, Kumar Shanmugam Dinesh, Swami Kannan Bharath Duraisamy, Tirupathi Raghavendra, Dalal Rutul
机构信息
Northeast Georgia Medical Center, Gainesville, GA, United States.
Shanghai Medical College, Fudan University, Shanghai, China.
出版信息
Front Oncol. 2024 Oct 17;14:1446482. doi: 10.3389/fonc.2024.1446482. eCollection 2024.
BACKGROUND
By 2023, COVID-19 had caused 6.8 million deaths in the United States. COVID-19 presents more severely in leukemia compared to solid tumors (OR 1.6, p<0.05). However, data on Acute Myeloid Leukemia (AML) and Myelodysplastic Syndrome (MDS) are limited. We investigated the mortality in AML and MDS patients with COVID-19.
METHODS
Data from the 2020-2021 National Inpatient Sample was used to conduct a cross-sectional analysis. We identified AML and MDS patients with COVID-19 hospitalizations through ICD-10 codes. Analysis was done by propensity matching and multivariate regression with a p-value of ≤0.05.
RESULTS
Of 28,028 AML admissions, 336 (1.2%) were admitted for COVID-19. AML-COVID-19 cohort had a lower hospitalization risk (aOR 0.3, p=0.000) and higher mortality (21.7% vs 8.7%; aOR 1.6, p=0.023) than AML patients admitted for other causes. AML patients post-HSCT (Hematopoietic Stem Cell Transplantation) had a higher risk of COVID-19 (20.2% vs 9.8%; aOR 2.6, p=0.000) and increased mortality (19.1% vs 6.7%; aOR 4.1, p=0.000) compared to other causes. Similarly, of 28,148 MDS patients, 769 (2.7%) were admitted for COVID-19. The MDS-COVID-19 cohort had a lower hospitalization risk (aOR 0.59, p=0.000) and higher mortality (19.6% vs 6.6%; aOR 2.2, p=0.000) compared to other causes. In MDS, HSCT did not alter the risk of COVID-19 hospitalizations (3% vs 3.9%; aOR 0.9, p=0.662), but these patients had higher mortality (17.4% vs 5.1%; aOR 4.0, p=0.032).
CONCLUSION
COVID-19 hospitalization was low in AML and MDS but carried a high mortality risk. Post-HSCT, the mortality is high, warranting research into understanding the underlying factors.
背景
截至2023年，新冠病毒病在美国已导致680万人死亡。与实体瘤相比，新冠病毒病在白血病患者中表现更为严重（比值比1.6，p<0.05）。然而，关于急性髓系白血病（AML）和骨髓增生异常综合征（MDS）的数据有限。我们调查了新冠病毒病合并AML和MDS患者的死亡率。
方法
利用2020 - 2021年全国住院患者样本数据进行横断面分析。我们通过国际疾病分类第十版（ICD - 10）编码识别出因新冠病毒病住院的AML和MDS患者。采用倾向匹配和多因素回归分析，p值≤0.05。
结果
在28028例AML住院患者中，336例（1.2%）因新冠病毒病入院。与因其他原因入院的AML患者相比，AML合并新冠病毒病队列的住院风险较低（校正后比值比0.3，p = 0.000），但死亡率较高（21.7%对8.7%；校正后比值比1.6，p = 0.023）。与因其他原因入院的患者相比，接受造血干细胞移植（HSCT）后的AML患者感染新冠病毒病的风险更高（20.2%对9.8%；校正后比值比2.6，p = 0.000），死亡率也更高（19.1%对6.7%；校正后比值比4.1，p = 0.000）。同样，在28148例MDS患者中，769例（2.7%）因新冠病毒病入院。与因其他原因入院的患者相比，MDS合并新冠病毒病队列的住院风险较低（校正后比值比0.59，p = 0.000），但死亡率较高（19.6%对6.6%；校正后比值比2.2，p = 0.000）。在MDS中，HSCT并未改变新冠病毒病住院风险（3%对3.9%；校正后比值比0.9，p = 0.662），但这些患者的死亡率较高（17.4%对5.1%；校正后比值比4.0，p = 0.032）。
结论
AML和MDS患者中新冠病毒病住院率较低，但死亡风险较高。HSCT后，死亡率很高，需要开展研究以了解潜在因素。
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