| Hui Peng,Sheng Wang,Qi Mei,Yuhong Dai,Jian Li,Ming Li,Kathrin Halfter,Xueyan Jiang,Qin Huang,Lei Wang,Wei Wei,Ru Liu,Zhen cao,Motuma Yigezu Daba,Fangfang Wang,Bingqing Zhou,Hong Qiu,Xianglin Yuan. Comparable outcomes but higher risks of prolonged viral RNA shedding duration and secondary infection in cancer survivors with COVID-19: A multi-center, matched retrospective cohort study*. Oncol Transl Med, 2020, 6: 237-246. |
| COVID-19癌症幸存者具有可比结果，但病毒RNA脱落持续时间延长和继发感染的风险较高：一项多中心，配对回顾性队列研究 |
| Comparable outcomes but higher risks of prolonged viral RNA shedding duration and secondary infection in cancer survivors with COVID-19: A multi-center, matched retrospective cohort study* |
| Received:November 12, 2020 Revised:December 29, 2020 |
| DOI：10.1007/s10330-020-0469-9 |
| 中文关键词: COVID-19；SARS-CoV-2；癌症幸存者；预后；病毒脱落；死亡 |
| 英文关键词: COVID-19; SARS-CoV-2; cancer survivor; prognosis; viral shedding; mortality |
| 基金项目: |
| Author Name | Affiliation | E-mail | | Hui Peng | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | denice1010@163.com | | Sheng Wang | Department of Radiotherapy, Zhongda Hospital, Medical College of Southeast University | | | Qi Mei | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Yuhong Dai | Institute of Experimental Immunology, University Clinic of Rheinische Friedrich-Wilhelms-University, Bonn , Germany | | | Jian Li | Department of Oncology, Wuhan Pulmonary Hospital | | | Ming Li | Tumor Register Munich, Ludwig-Maximilian-University, Munich , Germany | | | Kathrin Halfter | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, , China | | | Xueyan Jiang | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Qin Huang | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Lei Wang | Dangyang People’s Hospital | | | Wei Wei | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Ru Liu | Department of Pulmonary Vascular and General Medicine, Fuwai Yunnan Cardiovascular Hospital | | | Zhen cao | Whhan wuchang hospital,Wuhan, Hubei, China | | | Motuma Yigezu Daba | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Fangfang Wang | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Bingqing Zhou | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Hong Qiu | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | | | Xianglin Yuan* | Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology | xlyuan1020@163.com |
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| 中文摘要: |
| 目的：研究2019年冠状病毒病（COVID-19）癌症幸存者和非癌症患者的临床特征和预后之间的差异。
方法：在这项于2020年2月10日至2020年3月31日在中国武汉进行的多中心，回顾性和观察性队列研究中，筛选出所有感染了COVID-19的癌症幸存者，并使用统计学方法对非COVID-19癌症患者进行统计学匹配，对人口统计、临床、实验室检查结果和治疗方法进行评估。
结果：从武汉市四家医院的2828例COVID-19感染患者中筛选出61例癌症幸存者和183例匹配的非癌患者。癌症幸存者队列和非癌患者队列的中位年龄分别为64.0（55.0-73.0）和64.0（54.0-73.5）岁（P = 0.909）。癌症幸存者的发病症状多于非癌症患者。发热（80.3％：65.0％，P = 0.026）是最普遍的发作症状，其次是咳嗽（65.6％：37.7％; P <.001），肌肉酸痛和疲劳（45.9％：13.6％; P < 0.001）。发生严重事件的风险（调整后的危险比[AHR] = 1.25； 95％置信区间[CI]：0.76-2.06； P = 0.378）和死亡率（相对风险[RR] = 0.90，95％CI：0.79-1.04； P = 0.416），癌症幸存者队列与匹配的非癌症患者队列中的CI相当。但是，癌症幸存者队列显示出更高的继发感染率（52.5％：30.1％； RR = 1.47，95％[CI]：1.11-1.95； P = 0.002），并且病毒RNA脱落时间延长（32天[IQR 26.0-46.0] ]：24.0天[IQR 18.0-33.0]； AHR = 0.54； 95％CI：0.38-0.80； P <0.05）。
结论：与非癌症患者相比，COVID-19癌症幸存者表现出更高的继发感染率，病毒脱落时间延长，但发生严重事件和死亡的风险相当。对于临床医生而言，采取个体化措施来治疗COVID-19的癌症幸存者是有帮助的。 |
| 英文摘要: |
| Objective To identify the differences in clinical features and outcomes between cancer survivors and
non-cancer patients with coronavirus disease 2019 (COVID-19).
Methods In this multicenter, retrospective, and observational cohort study from February 10, 2020 to March
31, 2020 in Wuhan, China, all cancer survivors infected with COVID-19 were screened, and statistically
matched with non-cancer patients with COVID-19 using propensity score matching. Demographic, clinical,
treatment, and laboratory data were extracted from a standardized medical recording system and underwent
review and assessment.
Results Sixty-one cancer survivors and 183 matched non-cancer patients were screened from 2,828
COVID-19 infected patients admitted to 4 hospitals in Wuhan, China. The median ages of the cancer survivor
cohort and non-cancer patient cohort were 64.0 (55.0–73.0) and 64.0 (54.0–73.5), respectively (P = 0.909).
Cancer survivors reported a higher incidence of symptom onset than non-cancer patients. Fever (80.3% vs.
65.0%; P = 0.026) was the most prevalent symptom, followed by cough (65.6% vs. 37.7%; P < 0.001), myalgia,
and fatigue (45.9% vs. 13.6%; P < 0.001). The risks of the development of severe events (adjusted hazard ratio
[AHR] = 1.25; 95% confidence interval [CI]: 0.76–2.06; P = 0.378) and mortality (relative risk [RR] = 0.90, 95%
CI: 0.79–1.04; P = 0.416) in the cancer survivor cohort were comparable to those of the matched non-cancer
patient cohort. However, the cancer survivor cohort showed a higher incidence of secondary infection (52.5%
vs. 30.1%; RR = 1.47, 95% CI: 1.11–1.95; P = 0.002) and a prolonged viral RNA shedding duration (32 days
[IQR 26.0–46.0] vs.24.0 days [IQR 18.0–33.0]; AHR = 0.54; 95% CI: 0.38–0.80; P < 0.05).
Conclusion Compared to non-cancer patients, cancer survivors with COVID-19 exhibited a higher incidence
of secondary infection, a prolonged period of viral shedding, but comparable risks of the development of
severe events and mortality. It is helpful for clinicians to take tailored measures to treat cancer survivors with
COVID-19. |
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