Jalloh Abdulai Tejan, Merson Laura, Nair Divya, Hassan Shermarke, Kamara Ibrahim Franklyn, Nuwagira Innocent, Tengbe Sia Morenike, Tejan Yusuf Sheku, Kabba Mustapha, Lakoh Sulaiman, Grant Donald S, Samuels Robert J, Kamara Rugiatu Z, Terry Robert F
Ministry of Health, Government of Sierra Leone, Freetown, Sierra Leone.
ISARIC, Pandemic Science Institute, University of Oxford, Oxford, England, UK.
F1000Res. 2025 Apr 7;13:673. doi: 10.12688/f1000research.150761.2. eCollection 2024.
The coronavirus disease 2019 (COVID-19) has caused substantial morbidity and mortality on a global scale. A strong correlation has been found between COVID-19 treatment outcomes and noncommunicable diseases such as cancers. However, there is limited information on the outcomes of cancer patients who were hospitalised for COVID-19.
We conducted an analysis on data collected in a large prospective cohort study set-up by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). All patients with laboratory-confirmed or clinically-diagnosed SARS-CoV-2 infection were included. Cancer was defined as having a current solid organ or haematological malignancy. The following outcomes were assessed; 30-day in-hospital mortality, intensive care unit (ICU) admission, length of hospitalization and receipt of higher-level care.
Of the 560,547 hospitalised individuals who were analysed, 27,243 (4.9%) had cancer. Overall, cancer patients were older and had more comorbidities than non-cancer patients. Patients with cancer had higher 30-day in-hospital mortality than non-cancer patients (29.1.3% vs 18.0%) and longer hospital stays (median of 12 days vs 8 days). However, patients with cancer were admitted less often to intensive care units than non-cancer patients (12.6% vs 17.1%) and received less invasive mechanical ventilation than non-cancer patients (4.5% vs 7.6%). The hazard ratio of dying from cancer, adjusted for age, sex and country income level was 1.18 (95%CI: 1.15-1.2).
This study's findings underscore the heightened vulnerability of hospitalized COVID-19 patients with cancer, revealing a higher mortality rate, longer hospital stays, and an unstructured pattern of care that reflects the complexity of managing severely ill patients during a public health crisis like the COVID-19 pandemic.
2019年冠状病毒病(COVID-19)在全球范围内已造成大量发病和死亡。人们发现COVID-19的治疗结果与癌症等非传染性疾病之间存在密切关联。然而,关于因COVID-19住院的癌症患者的治疗结果信息有限。
我们对国际严重急性呼吸和新发感染联盟(ISARIC)开展的一项大型前瞻性队列研究收集的数据进行了分析。纳入所有实验室确诊或临床诊断为SARS-CoV-2感染的患者。癌症定义为目前患有实体器官或血液系统恶性肿瘤。评估了以下结果:30天院内死亡率、重症监护病房(ICU)收治情况、住院时间以及接受高级护理情况。
在分析的560547名住院患者中,27243名(4.9%)患有癌症。总体而言,癌症患者比非癌症患者年龄更大,合并症更多。癌症患者的30天院内死亡率高于非癌症患者(29.1%对18.0%),住院时间更长(中位数为12天对8天)。然而,癌症患者进入重症监护病房的比例低于非癌症患者(12.6%对17.1%),接受有创机械通气的比例低于非癌症患者(4.5%对7.6%)。经年龄、性别和国家收入水平调整后,因癌症死亡的风险比为1.18(95%置信区间:1.15 - 1.2)。
本研究结果强调了COVID-19住院癌症患者的更高脆弱性,揭示了更高的死亡率、更长的住院时间以及无规律的护理模式,这反映了在像COVID-19大流行这样的公共卫生危机期间管理重症患者的复杂性。