COVID-19 in patients with and without cancer: Examining differences in patient characteristics and outcomes.
COVID-19 in patients with and without cancer: Examining differences in patient characteristics and outcomes.
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DOI：
10.46439/cancerbiology.2.019
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Tewari AK
中科院分区：
文献类型：
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作者：
Mohamed NE;Benn EK;Astha V;Shah QN;Gharib Y;Kata HE;Honore-Goltz H;Dovey Z;Kyprianou N;Tewari AK
这项研究考察了癌症患者和非癌症患者在患者人口统计、临床特征和新冠肺炎死亡率方面的差异，并讨论了这些差异与现有癌症差异和新冠肺炎脆弱性的关系。数据是在2020年3月28日至2020年4月26日对西奈山卫生系统的一组新冠肺炎阳性患者进行的回顾性研究中收集的。应用描述性分析、比较分析和回归分析来检验患有癌症和非癌症患者在人口统计学、临床特征和新冠肺炎死亡率方面的差异，以及癌症状况是否可以预测新冠肺炎死亡率，并使用SAS9.4对这些协变量进行控制。结果显示，在4,641名新冠肺炎检测呈阳性的患者中，5.1%(N=236)患上了癌症。总样本的中位年龄为58岁(第一季度至第三季度：41-71岁)；55.3%为男性，19.2%为现在/以前吸烟者，6.1%为肥胖者。最常见的合并症是高血压(22.6%)和糖尿病(16.0%)。总体而言，新冠肺炎的死亡率为8.3%。研究新冠肺炎患者与非癌症患者之间的差异发现，新冠肺炎患者在新冠肺炎死亡率、住院率、年龄、性别、种族、吸烟状况、肥胖和共病指标(如糖尿病)方面存在显著差异(P<；0.05)，癌症患者更有可能是年龄较大、男性、黑人、肥胖、吸烟者和既有并存疾病的患者。控制这些临床、人口学和行为特征，Logistic回归分析结果显示，年龄和男性性别对新冠肺炎死亡率有显著影响(p<；0.05)。虽然患有新冠肺炎的癌症患者更有可能经历更糟糕的新冠肺炎预后，但这些关联可能与常见的癌症和新冠肺炎易感性因素有关，如年龄和性别。这些脆弱的年龄和性别因素在癌症和新冠肺炎人群中共存，强调了需要更好地了解它们对癌症和新冠肺炎差异的影响，以及疾病预防工作、政策和临床管理。
This study examines differences between patients with and without cancer in patient demographic and clinical characteristics and COVID-19 mortality and discusses the implications of these differences in relation to existing cancer disparities and COVID-19 vulnerabilities. Data was collected as a part of a retrospective study on a cohort of COVID-19 positive patients across Mount Sinai Health System from March 28, 2020 to April 26, 2020. Descriptive, comparative, and regression analyses were applied to examine differences between patients with and without cancer in demographic and clinical characteristics and COVID-19 mortality and whether cancer status predicts COVID-19 mortality controlling for these covariates using SAS 9.4. Results showed that, of 4641 patients who tested positive for COVID-19, 5.1% (N=236) had cancer. The median age of the total sample was 58 years (Q1-Q3: 41–71); 55.3% were male, 19.2% were current/former smokers, 6.1% were obese. The most commonly reported comorbidities were hypertension (22.6%) and diabetes (16.0%). Overall, the COVID-19 mortality rate was 8.3%. Examining differences between COVID-19 patients with and without cancer revealed significant differences (p<0.05) in COVID-19 mortality, hospitalization rates, age, gender, race, smoking status, obesity, and comorbidity indicators (e.g., diabetes) with cancer patients more likely to be older, male, black, obese, smokers, and with existing comorbidities. Controlling for these clinical, demographic, and behavioral characteristics, results of logistic regression analyses showed significant effects of older age and male gender on COVID-19 mortality (p<0.05). While cancer patients with COVID-19 were more likely to experience worse COVID-19 outcomes, these associations might be related to common cancer and COVID-19 vulnerability factors such as older age and gender. The coexistence of these vulnerability age and gender factors in both cancer and COVID-19 populations emphasizes the need for better understanding of their implications for cancer and COVID-19 disparities, both diseases prevention efforts, policies, and clinical management.