Risk Factors and Mortality of COVID-19 in Patients With Lymphoma: A Multicenter Study.
Risk Factors and Mortality of COVID-19 in Patients With Lymphoma: A Multicenter Study.
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DOI：
10.1097/hs9.0000000000000538
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发表时间：
2021-03
期刊：
影响因子：
6.6
通讯作者：
Bastos-Oreiro M
中科院分区：
文献类型：
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作者：
Regalado-Artamendi I;Jiménez-Ubieto A;Hernández-Rivas JÁ;Navarro B;Núñez L;Alaez C;Córdoba R;Peñalver FJ;Cannata J;Estival P;Quiroz-Cervantes K;Riaza Grau R;Velasco A;Martos R;Domingo-González A;Benito-Parra L;Gómez-Sanz E;López-Jiménez J;Matilla A;Herraez MR;Penalva MJ;García-Suárez J;Díez-Martín JL;Bastos-Oreiro M
癌症患者在 2019 年冠状病毒病 (COVID-19) 系列中代表性较差，并且已发布了有关血液学患者的异质系列。本研究旨在分析 COVID-19 对淋巴瘤患者的影响。我们提出了一项来自西班牙马德里 19 个中心的多中心回顾性研究，评估了患有 COVID-19 和淋巴瘤的成年患者死亡的危险因素。大约 177 名患者（55.9% 为男性）被纳入其中，中位随访时间为 27 天，中位年龄为 70 岁。在确诊 COVID-19 时，49.7% 的患者正在接受积极治疗。总死亡率为34.5%。年龄>70岁、精神错乱、尿素浓度、呼吸频率、血压、年龄>65分≥2、心脏病和慢性肾脏病与较高的死亡风险相关（P<0.05）。活动性疾病显着增加死亡风险（风险比，2.43；95% 置信区间，1.23-4.77；P = 0.01）。然而，积极治疗并没有改变死亡风险，并且不同治疗方案之间没有发现差异。严重急性呼吸综合征冠状病毒 2 阳性聚合酶链反应在第 6 周后持续存在与死亡率显着相关（54.5% 对比 1.4%；P < 0.001）。我们确认与一般人群相比死亡率有所增加。鉴于我们的结果，考虑到积极治疗尚未被证明会增加死亡风险，并且实现疾病缓解可能会带来更好的结果，因此任何中断或延迟开始治疗的行为都应该受到质疑。
Patients with cancer are poorly represented in coronavirus disease 2019 (COVID-19) series, and heterogeneous series concerning hematology patients have been published. This study aimed to analyze the impact of COVID-19 in patients with lymphoma. We present a multicenter retrospective study from 19 centers in Madrid, Spain, evaluating risk factors for mortality in adult patients with COVID-19 and lymphoma. About 177 patients (55.9% male) were included with a median follow-up of 27 days and a median age of 70 years. At the time of COVID-19 diagnosis, 49.7% of patients were on active treatment. The overall mortality rate was 34.5%. Age >70 years, confusion, urea concentration, respiratory rate, blood pressure, and age >65 score ≥2, heart disease, and chronic kidney disease were associated with higher mortality risk (P < 0.05). Active disease significantly increased the risk of death (hazard ratio, 2.43; 95% confidence interval, 1.23-4.77; P = 0.01). However, active treatment did not modify mortality risk and no differences were found between the different therapeutic regimens. The persistence of severe acute respiratory syndrome coronavirus 2-positive polymerase chain reaction after week 6 was significantly associated with mortality (54.5% versus 1.4%; P < 0.001). We confirm an increased mortality compared with the general population. In view of our results, any interruption or delay in the start of treatment should be questioned given that active treatment has not been demonstrated to increase mortality risk and that achieving disease remission could lead to better outcomes.