Utilization of COVID-19 Treatments and Clinical Outcomes among Patients with Cancer: A COVID-19 and Cancer Consortium (CCC19) Cohort Study.
Utilization of COVID-19 Treatments and Clinical Outcomes among Patients with Cancer: A COVID-19 and Cancer Consortium (CCC19) Cohort Study.
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DOI：
10.1158/2159-8290.cd-20-0941
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发表时间：
2020-10
期刊：
影响因子：
28.2
通讯作者：
COVID-19 and Cancer Consortium
中科院分区：
文献类型：
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作者：
Rivera DR;Peters S;Panagiotou OA;Shah DP;Kuderer NM;Hsu CY;Rubinstein SM;Lee BJ;Choueiri TK;de Lima Lopes G Jr;Grivas P;Painter CA;Rini BI;Thompson MA;Arcobello J;Bakouny Z;Doroshow DB;Egan PC;Farmakiotis D;Fecher LA;Friese CR;Galsky MD;Goel S;Gupta S;Halfdanarson TR;Halmos B;Hawley JE;Khaki AR;Lemmon CA;Mishra S;Olszewski AJ;Pennell NA;Puc MM;Revankar SG;Schapira L;Schmidt A;Schwartz GK;Shah SA;Wu JT;Xie Z;Yeh AC;Zhu H;Shyr Y;Lyman GH;Warner JL;COVID-19 and Cancer Consortium
在 2,186 名患有侵袭性癌症并经实验室确诊的 SARS-CoV-2 感染的美国成年人中，我们研究了 COVID-19 治疗与 30 天全因死亡率的关系以及与治疗相关的因素。进行了多项调整（例如合并症、癌症状态、基线 COVID-19 严重程度）的逻辑回归。与羟氯喹或未经治疗的对照组以外的任何 COVID-19 治疗方法相比，羟氯喹与任何其他药物联合使用都会增加死亡率；单独使用羟氯喹时不存在这种关联。与未经治疗的对照组相比，瑞德西韦在数值上降低了死亡率，但未达到统计学显着性。 COVID-19 基线严重程度与接受任何治疗密切相关。黑人患者接受瑞德西韦治疗的可能性大约是白人患者的一半。虽然观察性研究可能受到潜在的无法测量的混杂因素的限制，但我们的研究结果增加了人们对癌症和 COVID-19 患者护理模式的新认识，并支持通过包括该人群的前瞻性对照试验来评估新兴治疗方法。
Among 2,186 US adults with invasive cancer and laboratory-confirmed SARS-CoV-2 infection, we examined the association of COVID-19 treatments with 30-day all-cause mortality, and factors associated with treatment. Logistic regression with multiple adjustments (e.g., comorbidities, cancer status, baseline COVID-19 severity) was performed. Hydroxychloroquine with any other drug was associated with increased mortality versus treatment with any COVID-19 treatment other than hydroxychloroquine or untreated controls; this association was not present with hydroxychloroquine alone. Remdesivir had numerically reduced mortality versus untreated controls that did not reach statistical significance. Baseline COVID-19 severity was strongly associated with receipt of any treatment. Black patients were approximately half as likely to receive remdesivir as white patients. While observational studies can be limited by potential unmeasured confounding, our findings add to the emerging understanding of patterns of care for patients with cancer and COVID-19 and support evaluation of emerging treatments through prospective controlled trials inclusive of this population.