Outcomes of patients with hematologic malignancies and COVID-19: a systematic review and meta-analysis of 3377 patients.
Outcomes of patients with hematologic malignancies and COVID-19: a systematic review and meta-analysis of 3377 patients.
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血液学恶性肿瘤和共同19岁的患者的结局：3377例患者的系统评价和荟萃分析。
DOI：
10.1182/blood.2020008824
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发表时间：
2020-12-17
期刊：
影响因子：
20.3
通讯作者：
Hicks LK
中科院分区：
文献类型：
--
作者：
Vijenthira A;Gong IY;Fox TA;Booth S;Cook G;Fattizzo B;Martín-Moro F;Razanamahery J;Riches JC;Zwicker J;Patell R;Vekemans MC;Scarfò L;Chatzikonstantinou T;Yildiz H;Lattenist R;Mantzaris I;Wood WA;Hicks LK
出版者注：这期杂志上有关于这篇文章的评论。患有血液恶性肿瘤和COVID-19的成年患者的死亡风险为34%，而儿科患者的死亡风险为4%。接受全身抗癌治疗的患者与未接受治疗的患者的死亡风险相似（RR, 1.17; 95% CI, 0.83-1.64）。感染COVID-19的血液恶性肿瘤患者的结局尚未汇总。本研究的目的是进行系统回顾和荟萃分析，以估计这些患者的死亡风险和其他重要结局。我们检索了截至2020年8月20日的PubMed和EMBASE，以确定血液恶性肿瘤和COVID-19患者的报告。主要结局是综合死亡率估计，考虑所有患者和仅住院患者。次要结局包括住院患者进入重症监护病房和通气的风险。亚组分析包括按年龄、治疗状况和恶性肿瘤亚型分层的死亡率。采用随机效应模型计算合并患病率、风险比（rr）和95%置信区间（ci）。纳入了来自亚洲、欧洲和北美的34项成人研究和5项儿科研究（3377例患者）（34项成人研究中有14项仅纳入住院患者）。在以住院患者为主的样本中，成年患者的死亡风险为34% （95% CI, 28-39; N = 3240）。≥60岁患者的死亡风险明显高于<60岁患者（RR, 1.82; 95% CI, 1.45-2.27; N = 1169）。儿科患者的死亡风险为4% （95% CI, 1-9; N = 102）。近期接受全身抗癌治疗的患者与未接受治疗的患者的死亡RR为1.17 （95% CI, 0.83-1.64; N = 736）。成人血液恶性肿瘤合并COVID-19患者，特别是住院患者死亡风险高。≥60岁的患者死亡率明显较高；儿科患者似乎相对幸免。最近的癌症治疗似乎并没有显著增加死亡的风险。
Publisher's Note: There is a on this article in this issue. Adult patients with hematologic malignancy and COVID-19 found a 34% risk of death, whereas pediatric patients had a 4% risk of death. Patients on systemic anticancer therapy had a similar risk of death to patients on no treatment (RR, 1.17; 95% CI, 0.83-1.64). Outcomes for patients with hematologic malignancy infected with COVID-19 have not been aggregated. The objective of this study was to perform a systematic review and meta-analysis to estimate the risk of death and other important outcomes for these patients. We searched PubMed and EMBASE up to 20 August 2020 to identify reports of patients with hematologic malignancy and COVID-19. The primary outcome was a pooled mortality estimate, considering all patients and only hospitalized patients. Secondary outcomes included risk of intensive care unit admission and ventilation in hospitalized patients. Subgroup analyses included mortality stratified by age, treatment status, and malignancy subtype. Pooled prevalence, risk ratios (RRs), and 95% confidence intervals (CIs) were calculated using a random-effects model. Thirty-four adult and 5 pediatric studies (3377 patients) from Asia, Europe, and North America were included (14 of 34 adult studies included only hospitalized patients). Risk of death among adult patients was 34% (95% CI, 28-39; N = 3240) in this sample of predominantly hospitalized patients. Patients aged ≥60 years had a significantly higher risk of death than patients <60 years (RR, 1.82; 95% CI, 1.45-2.27; N = 1169). The risk of death in pediatric patients was 4% (95% CI, 1-9; N = 102). RR of death comparing patients with recent systemic anticancer therapy to no treatment was 1.17 (95% CI, 0.83-1.64; N = 736). Adult patients with hematologic malignancy and COVID-19, especially hospitalized patients, have a high risk of dying. Patients ≥60 years have significantly higher mortality; pediatric patients appear to be relatively spared. Recent cancer treatment does not appear to significantly increase the risk of death.
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