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癌症与2019冠状病毒病之间的相互作用:风险因素与靶向干预措施。

The interaction between cancer and COVID-19: Risk factors and targeted interventions.

作者信息

da Silva Viana Lucian, Chung Filho Alython Araujo, Monteiro Gina Torres Rego, Sobral Andrea

机构信息

Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.

Research Center, National Cancer Institute (INCA), Rio de Janeiro, Brazil.

出版信息

PLoS One. 2025 Jun 3;20(6):e0319970. doi: 10.1371/journal.pone.0319970. eCollection 2025.

Abstract

BACKGROUND

Cancer patients are particularly fragile, and hospitalization represents a significant additional risk for complications and death, especially given the vulnerability of this group during the global pandemic. The study objective entails analyzing the factors associated with severity and death of cancer patients diagnosed with COVID-19 hospitalized between 2020 and 2022, in the city of Rio de Janeiro, Brazil.

MATERIALS AND METHODS

This is a cross-sectional study, with hospitalized patients with both diagnoses, cancer and COVID-19, through two national databases. Bivariate and multivariate regression analyses were performed, followed by an interaction analysis between the variables of interest in the multivariate regression.

FINDINGS

A total of 1,336 cases were analyzed. Have comorbidity and hematological neoplasms were associated with mechanical ventilation (OR =  1.62 and OR =  2.14, respectively) and with ICU admission (OR =  1.44 and OR =  2.25, respectively). The age group of 60 years or older (OR =  1.33), have multimorbidity (OR =  1.38), and use mechanic ventilation (OR =  2.39) were associated with a higher risk of death from COVID-19. The multimorbidity had a synergistic effect with hospitalization before vaccination (AP =  0.29; 95%CI =  0.01 - 0.58) and the use of mechanical ventilation (AP =  0.54; 95%CI =  0.18 - 0.98).

INTERPRETATION

These findings are crucial to guide clinical decisions, improve the management of care for these patients, and optimize the use of health resources in the epidemiological context imposed by the pandemic.

摘要

背景

癌症患者格外脆弱,住院会带来并发症和死亡的显著额外风险,尤其是考虑到在全球大流行期间该群体的脆弱性。本研究目的是分析2020年至2022年期间在巴西里约热内卢市住院的确诊感染新冠病毒的癌症患者的严重程度和死亡相关因素。

材料与方法

这是一项横断面研究,通过两个国家数据库纳入同时患有癌症和新冠病毒两种诊断的住院患者。进行了双变量和多变量回归分析,随后对多变量回归中感兴趣的变量进行了交互分析。

研究结果

共分析了1336例病例。患有合并症和血液系统肿瘤分别与机械通气(比值比分别为1.62和2.14)以及入住重症监护病房(比值比分别为1.44和2.25)相关。60岁及以上年龄组(比值比为1.33)、患有多种合并症(比值比为1.38)以及使用机械通气(比值比为2.39)与新冠病毒死亡风险较高相关。多种合并症与接种疫苗前住院(归因比例为0.29;95%置信区间为0.01 - 0.58)和使用机械通气(归因比例为0.54;95%置信区间为0.18 - 0.98)具有协同效应。

解读

这些发现对于指导临床决策、改善这些患者的护理管理以及在大流行带来的流行病学背景下优化卫生资源的使用至关重要。

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