COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study
COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study
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DOI：
10.1016/s1470-2045(20)30442-3
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发表时间：
2020-10-01
期刊：
影响因子：
51.1
通讯作者：
Kerr, Rachel
中科院分区：
文献类型：
--
作者：
Lee, Lennard Y. W.;Cozier, Jean-Baptiste;Kerr, Rachel
据称，癌症患者的COVID-19预后较差。然而，癌症是一组异质性的疾病，包括一系列的肿瘤亚型。本研究的目的是根据英国癌症患者的肿瘤亚型和患者人口统计数据调查COVID-19的风险。方法：将2020年3月18日至5月8日英国冠状病毒癌症监测项目（UKCCMP）队列中登记的成年癌症患者与英国国家统计局（2017年数据）的非covid -19英国癌症对照人群进行比较。该研究的主要结局是原发性肿瘤亚型、年龄和性别以及对住院期间严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）患病率和病死率的影响。我们使用单变量和多变量模型分析了肿瘤亚型和患者人口统计学（年龄和性别）对COVID-19患病率和死亡率的影响。结果：在UKCCMP队列中，1044例患者中有319例（30.6%）死亡，其中295例（92.5%）的死亡原因记录为COVID-19。SARS-CoV-2感染后癌症患者的全因病死率与年龄增长显著相关，40-49岁患者的病死率为0.10,80岁及以上患者的病死率为0.48。血液系统恶性肿瘤（白血病、淋巴瘤和骨髓瘤）患者与实体器官肿瘤患者相比，具有更严重的COVID-19轨迹(优势比[OR] 1.57, 95% CI 1.15-2.15
Background Patients with cancer are purported to have poor COVID-19 outcomes. However, cancer is a heterogeneous group of diseases, encompassing a spectrum of tumour subtypes. The aim of this study was to investigate COVID-19 risk according to tumour subtype and patient demographics in patients with cancer in the UK.Methods We compared adult patients with cancer enrolled in the UK Coronavirus Cancer Monitoring Project (UKCCMP) cohort between March 18 and May 8, 2020, with a parallel non-COVID-19 UK cancer control population from the UK Office for National Statistics (2017 data). The primary outcome of the study was the effect of primary tumour subtype, age, and sex and on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) prevalence and the case-fatality rate during hospital admission. We analysed the effect of tumour subtype and patient demographics (age and sex) on prevalence and mortality from COVID-19 using univariable and multivariable models.Findings 319 (30.6%) of 1044 patients in the UKCCMP cohort died, 295 (92.5%) of whom had a cause of death recorded as due to COVID-19. The all-cause case-fatality rate in patients with cancer after SARS-CoV-2 infection was significantly associated with increasing age, rising from 0.10 in patients aged 40-49 years to 0.48 in those aged 80 years and older. Patients with haematological malignancies (leukaemia, lymphoma, and myeloma) had a more severe COVID-19 trajectory compared with patients with solid organ tumours (odds ratio [OR] 1.57, 95% CI 1.15-2.15; p