2019冠状病毒病感染癌症患者的现实结局:北爱尔兰经验

Q3 Medicine Ulster Medical Journal Pub Date : 2023-01-01
Laura Feeney, Ashleigh Hamilton, Anita Lavery, Conor O'Neill, Gerard Walls, Kirsty Taylor, Richard C Turkington
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引用次数: 0

摘要

背景:癌症一直被认为与COVID-19的发病率和死亡率高风险相关。保护措施包括癌症治疗的改进。关于COVID-19感染的影响和癌症患者的预后,数据相互矛盾。我们的目标是描述英国冠状病毒癌症监测项目(UKCCMP)中报告的北爱尔兰癌症患者的人口统计学和临床特征对COVID-19结局的影响。方法:前瞻性数据收集,包括在UKCCMP中登记的所有北爱尔兰患者的人口统计学、癌症分期和类型、治疗和结局。主要终点是全因死亡率。采用SPSSv25进行描述性统计和logistic回归分析。结果:2020年3月至2021年3月,共登记病例110例。中位年龄为63岁(27 - 87岁)。60岁以上患者70例(63.6%),女性59例(53.8%)。83例(72.7%)患者报告了合并症。大多数患者有转移性疾病(64,58.2%)。67例患者(60.9%)在感染前4周内接受了抗癌治疗。其中35例(52.2%)接受了化疗。39例(58.2%)患者按计划继续治疗;24例(36.9%)因感染SARS-CoV-2而停止治疗。大多数患者无症状或症状轻微(66.7%,60.9%)。51人(46.3%)因COVID-19住院。重症/危重型COVID-19疾病的风险与年龄显著相关(OR 1.07 [95% CI 1.03-1.11]);p=0.004),既往高血压(OR 3.29 [95% CI 1.42-7.62];p=0.02)和胸部原发性恶性肿瘤(OR 4.41 [95% CI 1.52-12.74];p = 0.042)。死亡29例(26.3%),其中新冠肺炎死亡15例(57.7%),癌症死亡13例(44.8%)。死亡风险与年龄显著相关(OR 1.05 [95% CI 1.01-1.09];p=0.014),男性(OR 3.76 [95% CI 1.51-9.34];p=0.008)和胸部原发性恶性肿瘤(OR 5.35 [95% CI 1.88-15.25];p = 0.014)。在校正了年龄、性别和合并症后,过去4周内的化疗与死亡率没有显著相关(OR 0.65 [95% CI 0.20-2.11];p = 0.476)。结论:年龄和胸廓癌诊断与生存率相关。将大流行期间的表现与国家基准进行比较,可以为如何调整区域服务以应对未来的卫生保健危机提供信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Real world outcomes in cancer patients with COVID-19 infection: Northern Ireland experience.

Background: Cancer has been assumed to be associated with a high-risk of morbidity and mortality from COVID-19. Protective measures have incorporated modifications in cancer treatments. There are conflicting data about the impact of COVID-19 infection and outcomes in cancer patients. We aim to describe the impact of demographic and clinical characteristics on COVID-19 outcomes in patients with cancer in Northern Ireland reported within the UK Coronavirus Cancer Monitoring Project (UKCCMP).

Method: Prospective data collection including demographics, cancer stage and type, treatment and outcomes occurred for all Northern Irish patients enrolled in the UKCCMP. The primary endpoint was all-cause mortality. Descriptive statistics and logistic regression analysis were performed using SPSSv25.

Results: Between March 2020 and March 2021, 110 cases were registered. Median age was 63 years (range 27 to 87). Seventy patients (63.6%) were >60 years and 59 (53.8%) were females. Co-morbidities were reported in 83 patients (72.7%). Most patients had metastatic disease (64, 58.2%). Sixty-seven patients (60.9%) received anticancer treatment in the 4 weeks prior to COVID-19 infection. Of those patients, 35 (52.2%) received chemotherapy. Thirty-nine patients (58.2%) continued treatment as planned; 24 (36.9%) stopped treatment due to SARS-CoV-2 infection. The majority of patients were asymptomatic or experienced mild symptoms (67, 60.9%). Fifty-one (46.3%%) were admitted to hospital for COVID-19. Risk of severe/critical COVID-19 disease was significantly associated with age (OR 1.07 [95% CI 1.03-1.11); p=0.004), pre-existing hypertension (OR 3.29 [95% CI 1.42-7.62]; p=0.02) and thoracic primary malignancy (OR 4.41 [95% CI 1.52-12.74]; p=0.042). Twenty-nine patients (26.3%) died of whom 15 (57.7%) died of COVID-19 and 13 (44.8%) died due to cancer. Risk of death was significantly associated with age (OR 1.05 [95% CI 1.01-1.09]; p=0.014), male sex (OR 3.76 [95% CI 1.51-9.34]; p=0.008) and thoracic primary malignancy (OR 5.35 [95% CI 1.88-15.25]; p=0.014). When corrected for age, gender and co-morbidities, chemotherapy within the past 4 weeks was not significantly associated with mortality (OR 0.65 [95% CI 0.20-2.11]; p=0.476).

Conclusion: Age and thoracic cancer diagnosis correlated with survival. Comparison of performance during the pandemic with national benchmarks can inform how regional services should be adapted in preparation for future healthcare crises.

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Ulster Medical Journal
Ulster Medical Journal Medicine-Medicine (all)
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