Clinical and Virologic Characteristics and Outcomes of Coronavirus Disease 2019 at a Cancer Center.
Clinical and Virologic Characteristics and Outcomes of Coronavirus Disease 2019 at a Cancer Center.
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DOI：
10.1093/ofid/ofab193
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发表时间：
2021-06
影响因子：
4.2
通讯作者：
Liu C
中科院分区：
文献类型：
--
作者：
Yoke LH;Lee JM;Krantz EM;Morris J;Marquis S;Bhattacharyya P;So L;Riedo FX;Simmons J;Khaki AR;Cheng GS;Greninger AL;Pergam SA;Waghmare A;Ogimi C;Liu C
癌症和 2019 年冠状病毒病 (COVID-19) 患者的发病率和死亡率较高；然而，关于抗菌药物使用、合并感染和病毒脱落的数据有限。我们对西雅图癌症护理联盟在 2020 年 2 月 28 日至 2020 年 6 月 15 日期间诊断出患有 COVID-19 的成年患者进行了一项回顾性队列研究，以描述抗菌药物的使用、合并感染、病毒脱落以及诊断后 30 天内的结果。使用循环阈值作为病毒载量的代表。我们确定了病毒清除率，定义为截至 2020 年 7 月 30 日，使用严重急性呼吸综合征冠状病毒 2 逆转录聚合酶链反应结果连续 2 次呈阴性结果。纳入了 71 名患者，中位年龄为 61 岁； 59% 患有实体瘤。只有 3 名患者有呼吸道细菌合并感染的记录。与后期（2020年3月29日至6月15日；2/36）相比，研究早期（2020年2月29日至3月28日；12/34）更频繁地开出经验性抗生素治疗肺炎（P = .002）。从症状出现到病毒清除的中位天数为 37 天，病毒载量在症状出现后的前 7-10 天内迅速下降。诊断后 30 天内，29 名患者 (41%) 住院，12 名患者 (17%) 死亡。在调整后的模型中，每增加一种合并症，诊断后一个月内的存活天数和出院天数就会降低 45%。癌症中心的患者，尤其是患有多种合并症的患者，因 COVID-19 而出现不良结果的风险增加。在癌症患者中经常观察到病毒长时间脱落，其对传播和治疗策略的影响值得进一步研究。对癌症中心的成年 COVID-19 患者进行的一项回顾性研究表明，患有多种合并症的患者预后不良的风险增加。症状出现后 7-10 天内，病毒载量迅速下降，但观察到病毒脱落时间较长。
High morbidity and mortality have been observed in patients with cancer and coronavirus disease 2019 (COVID-19); however, there are limited data on antimicrobial use, coinfections, and viral shedding. We conducted a retrospective cohort study of adult patients at the Seattle Cancer Care Alliance diagnosed with COVID-19 between February 28, 2020 and June 15, 2020 to characterize antimicrobial use, coinfections, viral shedding, and outcomes within 30 days after diagnosis. Cycle threshold values were used as a proxy for viral load. We determined viral clearance, defined as 2 consecutive negative results using severe acute respiratory syndrome coronavirus 2 reverse-transcription polymerase chain reaction results through July 30, 2020. Seventy-one patients were included with a median age of 61 years; 59% had a solid tumor. Only 3 patients had documented respiratory bacterial coinfection. Empiric antibiotics for pneumonia were prescribed more frequently early in the study period (February 29–March 28, 2020; 12/34) compared to the later period (March 29–June 15, 2020; 2/36) (P = .002). The median number of days from symptom onset to viral clearance was 37 days with viral load rapidly declining in the first 7–10 days after symptom onset. Within 30 days of diagnosis, 29 (41%) patients were hospitalized and 12 (17%) died. Each additional comorbidity was associated with 45% lower odds of days alive and out of hospital in the month following diagnosis in adjusted models. Patients at a cancer center, particularly those with multiple comorbidities, are at increased risk of poor outcomes from COVID-19. Prolonged viral shedding is frequently observed among cancer patients, and its implications on transmission and treatment strategies warrant further study. A retrospective study of adult patients with COVID-19 at a cancer center demonstrates increased risk of poor outcomes among those with multiple comorbidities. Viral loads declined rapidly within 7–10 days after symptom onset, but prolonged shedding was observed.
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影响因子：
82.9
作者：
Robilotti EV;Babady NE;Mead PA;Rolling T;Perez-Johnston R;Bernardes M;Bogler Y;Caldararo M;Figueroa CJ;Glickman MS;Joanow A;Kaltsas A;Lee YJ;Lucca A;Mariano A;Morjaria S;Nawar T;Papanicolaou GA;Predmore J;Redelman-Sidi G;Schmidt E;Seo SK;Sepkowitz K;Shah MK;Wolchok JD;Hohl TM;Taur Y;Kamboj M
通讯作者：
Kamboj M
DOI：
10.1136/bmj.m4509
发表时间：
2020-11-27
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Pastor-Barriuso R;Pérez-Gómez B;Hernán MA;Pérez-Olmeda M;Yotti R;Oteo-Iglesias J;Sanmartín JL;León-Gómez I;Fernández-García A;Fernández-Navarro P;Cruz I;Martín M;Delgado-Sanz C;Fernández de Larrea N;León Paniagua J;Muñoz-Montalvo JF;Blanco F;Larrauri A;Pollán M;ENE-COVID Study Group
通讯作者：
ENE-COVID Study Group
DOI：
10.1016/j.cmi.2020.07.016
发表时间：
2020-12
期刊：
Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
影响因子：
--
作者：
Langford BJ;So M;Raybardhan S;Leung V;Westwood D;MacFadden DR;Soucy JR;Daneman N
通讯作者：
Daneman N
影响因子：
33.9
作者：
Roxby, Alison C.;Greninger, Alex;Neme, Santiago
通讯作者：
Neme, Santiago
影响因子：
11.8
作者：
Bartoletti, Michele;Pascale, Renato;Viale, Pierluigi
通讯作者：
Viale, Pierluigi