COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study
COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study
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DOI：
10.1016/s0140-6736(20)31173-9
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发表时间：
2020-06-20
期刊：
影响因子：
168.9
通讯作者：
Middleton, Gary
中科院分区：
文献类型：
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作者：
Lee, Lennard Y. W.;Cazier, Jean Baptiste;Middleton, Gary
癌症患者，特别是正在接受全身抗癌治疗的患者，被认为死于COVID-19的风险更高。这一推测对癌症患者的治疗有相当大的影响，但由于大流行的偶然性，支持这一假设的大型多中心研究的数据很少。我们的目的是描述癌症患者的临床和人口学特征以及COVID-19结局。在这项前瞻性观察性研究中，所有到我们的癌症中心网络就诊的活动性癌症患者都有资格加入英国冠状病毒癌症监测项目（UKCCMP）。UKCCMP是第一个COVID-19临床注册中心，可以向一线医生报告COVID-19对癌症患者的影响。符合条件的患者鼻或咽拭子RT-PCR检测为严重急性呼吸综合征冠状病毒2阳性。我们排除了影像学或临床诊断为COVID-19且RT-PCR检测阳性的患者。主要终点是全因死亡率，或出院，由患者住院期间的报告地点评估。从2020年3月18日至4月26日，我们分析了800名诊断为癌症和有症状的COVID-19患者。412例（52%）患者病程轻。226例（28%）患者死亡，死亡风险与患者年龄增长显著相关(优势比9.42 [95% CI 6.56-10.02]
Background Individuals with cancer, particularly those who are receiving systemic anticancer treatments, have been postulated to be at increased risk of mortality from COVID-19. This conjecture has considerable effect on the treatment of patients with cancer and data from large, multicentre studies to support this assumption are scarce because of the contingencies of the pandemic. We aimed to describe the clinical and demographic characteristics and COVID-19 outcomes in patients with cancer.Methods In this prospective observational study, all patients with active cancer and presenting to our network of cancer centres were eligible for enrolment into the UK Coronavirus Cancer Monitoring Project (UKCCMP). The UKCCMP is the first COVID-19 clinical registry that enables near real-time reports to frontline doctors about the effects of COVID-19 on patients with cancer. Eligible patients tested positive for severe acute respiratory syndrome coronavirus 2 on RT-PCR assay from a nose or throat swab. We excluded patients with a radiological or clinical diagnosis of COVID-19, without a positive RT-PCR test. The primary endpoint was all-cause mortality, or discharge from hospital, as assessed by the reporting sites during the patient hospital admission.Findings From March 18, to April 26, 2020, we analysed 800 patients with a diagnosis of cancer and symptomatic COVID-19. 412 (52%) patients had a mild COVID-19 disease course. 226 (28%) patients died and risk of death was significantly associated with advancing patient age (odds ratio 9.42 [95% CI 6.56-10.02]; p