Covid-19 and lung cancer: A greater fatality rate?
Covid-19 and lung cancer: A greater fatality rate?
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DOI：
10.1016/j.lungcan.2020.05.034
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发表时间：
2020-08-01
期刊：
影响因子：
5.3
通讯作者：
Angel Lara, Miguel
中科院分区：
文献类型：
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作者：
Rogado, Jacobo;Pangua, Cristina;Angel Lara, Miguel
背景：目前没有系列报道确定Covid-19感染肺癌患者的特征和结果，使我们能够明确保护患者的策略。在我们的研究中，我们确定在目前的欧洲大流行中心（西班牙马德里），在我们内科肿瘤科就诊的肺癌患者与我们中心的参考人群（32万人）之间，Covid-19感染的累积发病率和严重程度是否存在差异。我们还描述了与不良预后和Covid-19治疗结果相关的临床和人口统计学因素。患者和方法：我们回顾性分析了2020年3月5日至2020年4月7日在马德里里昂公主大学医院收治的所有Covid-19患者的1878份医疗记录，以检测Covid-19在肺癌患者中的累积发病率。我们还使用单变量和多变量logistic回归分析描述了Covid-19的治疗结果、死亡率和相关危险因素。结果：本中心总诊断肺癌患者为17/1878人（0.9%），而总参考人群为1878/32万人（p= 0.09）。本中心诊断为Covid-19的肺癌患者死亡率为9/17(52.3%)，而Covid-19患者死亡率为192/ 1878 （p< 0.0001）。与幸存者相比，死亡肺癌患者年龄较大：72岁对64.5岁（p= 0.12）。羟氯喹和阿奇霉素联合治疗改善了肺癌患者Covid-19的预后，该治疗组患者的死亡率仅为其他治疗组的1/6，单因素和多因素logistic回归分析差异均有统计学意义（OR 0.04, p= 0.018）。结论：肺癌患者死亡率高于普通人群。羟氯喹和阿奇霉素联合治疗似乎是一个很好的治疗选择。重要的是尽量减少去医院的次数（不取消他们的积极治疗），以减少院内传播。
Background: Currently there are no reported series determining the Covid-19 infected lung cancer patient ' s characteristics and outcome that allow us to clarify strategies to protect our patients.In our study we determine whether exists differences in cumulative incidence and severity of Covid-19 infection between lung cancer patients visiting our Medical Oncology department and the reference population of our center (320,000 people), in the current epicenter of the pandemic in Europe (Madrid, Spain).We also describe clinical and demographic factors associated with poor prognosis and Covid-19 treatment outcomes. Patients and methods: We retrospectively reviewed 1878 medical records of all Covid-19 patients who were admitted at Hospital Universitario Infanta Leonor of Madrid between March 5, 2020 and April 7, 2020, in order to detect cumulative incidence of Covid-19 in lung cancer patients. We also described Covid-19 treatment outcome, mortality and associated risk factors using univariate and multivariate logistic regression analysis.Results: 17/1878 total diagnosis in our center had lung cancer (0.9 %) versus 1878/320,000 of the total reference population (p= 0.09). 9/17 lung cancer patients with Covid-19 diagnosis died (52.3 %) versus 192/ 1878 Covid-19 patients in our center (p< 0.0001). Dead lung cancer patients were elderly compared to survivors: 72 versus 64.5 years old (p= 0.12). Combined treatment with hydroxychloroquine and azithromycin improves the outcome of Covid-19 in lung cancer patients, detecting only 1/6 deaths between patients under this treatment versus others treatment, with statistical significance in the univariate and multivariate logistic regression (OR 0.04, p= 0.018).Conclusions: Lung cancer patients have a higher mortality rate than general population. Combined hydroxychloroquine and azithromycin treatment seems like a good treatment option. It is important to try to minimize visits to hospitals (without removing their active treatments) in order to decrease nosocomial transmission.