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Lancet oncol:胸部恶性肿瘤感染COVID-19后的死亡率

2020-06-13 QQY MedSci原创

对感染COVID-19的癌症患者的早期报道提示,与一般人群相比,癌症患者感染COVID-19后的死亡率较高。考虑到胸部恶性肿瘤患者的年龄较大、吸烟习惯和合并的心肺疾病,以及癌症治疗,这类患者可能特别容

感染COVID-19的癌症患者的早期报道提示,与一般人群相比,癌症患者感染COVID-19后的死亡率较高。考虑到胸部恶性肿瘤患者的年龄较大、吸烟习惯和合并的心肺疾病,以及癌症治疗,这类患者可能特别容易感染COVID-19。本研究旨在研究重度急性呼吸综合征冠状病毒2 (SARS-CoV-2)感染对胸部恶性肿瘤的影响。

本研究的患者纳入标准是疑诊或确诊COVID-19的胸部恶性肿瘤(NSCLC、小细胞肺癌、间皮瘤、胸腺上皮肿瘤和其他肺神经内分泌肿瘤)患者。

2020年3月26日-4月12日,共从8个国家中筛选了200位感染COVID-19的胸部恶性肿瘤患者,中位年龄68.0(61.8-75.0)岁,其中72%的患者的ECOG表现状态0-1分,81%的患者有吸烟史,另外76%的患者为非小细胞肺癌,而且74%的患者在确诊COVID-19时正在癌症治疗中,57%的患者的癌症治疗仍处于一线治疗阶段。

152位(76%)患者住院治疗,66位(33%)患者死亡。134位符合ICU标准的患者中有13位(10%)住进了ICU;其余121位住进了医院的普通病房。单变量分析显示年龄大于65岁(OR 1.88, 95% 1.00–3.62)、有吸烟史(4.24, 1.70–12.95)、只接受化疗(2.54, 1.09–6.11)和任何合并症(2.65, 1.09–7.46)均与死亡风险增加有关。但在多变量分析中,只有吸烟史(OR 3.18,95% CI 1.11-9.06)与死亡风险增加相关。

本研究数据显示,随着COVID-19全球大流行的持续,胸部恶性肿瘤患者死亡率高,ICU入院率低。重症监护治疗是否能降低死亡率仍有待确定。

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    2020-12-22 minlingfeng
  2. [GetPortalCommentsPageByObjectIdResponse(id=1865845, encodeId=9df51865845ab, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Tue Dec 22 01:44:57 CST 2020, time=2020-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830689, encodeId=066e18306890b, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Feb 15 16:44:57 CST 2021, time=2021-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813747, encodeId=43ca813e47f2, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Thu Aug 27 08:06:54 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1604513, encodeId=d778160451329, content=<a href='/topic/show?id=a9e38423401' target=_blank style='color:#2F92EE;'>#胸部恶性肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84234, encryptionId=a9e38423401, topicName=胸部恶性肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Mon Jun 15 12:44:57 CST 2020, time=2020-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033833, encodeId=b264103383355, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sun Jun 14 00:44:57 CST 2020, time=2020-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038045, encodeId=6b83103804542, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sun Jun 14 00:44:57 CST 2020, time=2020-06-14, status=1, ipAttribution=)]
    2021-02-15 howi
  3. [GetPortalCommentsPageByObjectIdResponse(id=1865845, encodeId=9df51865845ab, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Tue Dec 22 01:44:57 CST 2020, time=2020-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1830689, encodeId=066e18306890b, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3f0227, createdName=howi, createdTime=Mon Feb 15 16:44:57 CST 2021, time=2021-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813747, encodeId=43ca813e47f2, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=137, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=64245268311, createdName=14818eb4m67暂无昵称, createdTime=Thu Aug 27 08:06:54 CST 2020, time=2020-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1604513, encodeId=d778160451329, content=<a href='/topic/show?id=a9e38423401' target=_blank style='color:#2F92EE;'>#胸部恶性肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84234, encryptionId=a9e38423401, topicName=胸部恶性肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=医者仁心, createdTime=Mon Jun 15 12:44:57 CST 2020, time=2020-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1033833, encodeId=b264103383355, content=顶刊就是不一样,质量很高,内容精彩!学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=goodbing, createdTime=Sun Jun 14 00:44:57 CST 2020, time=2020-06-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038045, encodeId=6b83103804542, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Sun Jun 14 00:44:57 CST 2020, time=2020-06-14, status=1, ipAttribution=)]
    2020-08-27 14818eb4m67暂无昵称

    学习了

    0

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    2020-06-14 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

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    2020-06-14 anti-cancer

    谢谢梅斯分享这么多精彩信息

    0

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由此可见,无论AF复发和重症监护的原因如何,在重症监护期间新诊断AF后存活的患者长期卒中/SE和死亡率的风险仍高于无AF患者。这些患者可能需要密切随访和持续抗凝治疗。

Intens Care Med:入院前暴露于空气污染会延长重症监护患者的人工通气时间

入住ICU之前,短期的环境空气污染暴露是ICU患者人工通气持续时间的危险因素。

Stroke:自发性脑内出血重症监护患者长期死亡率的预测因素

在重症监护病房治疗的ICH患者中,临床因素对于12个月死亡率预测比客观影像学因素更为重要。对于幕上和幕下ICHs,临床和影像学因素对结局的影响是不同的,强调这些不应被视为同一种临床情况。

瑞芬太尼在重症监护室镇痛镇静方案中的应用

提供有效的镇痛和充分的镇静是重症监护医学的普遍接受的目标。由于超短效的阿片类药物瑞芬太尼的快速、器官保护和代谢时间可预知等特性,使它对重症监护病房(ICU)中基于镇痛的镇静策略非常有用。

Prostate Cancer P D:接受重症监护治疗的转移性前列腺癌患者接受姑息治疗的当前趋势和社会障碍研究

在晚期癌症患者中使用住院病人姑息治疗(IPC)是较为完善的指南建议。之前的分析阐释了泌尿生殖系(GU)癌症患者在4个检查的原发性癌症(肺癌、乳腺癌、结直肠癌和GU)患者中受益于IPC的比例为排序第3。基于这些结果,研究人员在接受重症监护治疗(CCT)的转移前列腺癌(mPCa)患者中调查了IPC使用的当前趋势和预测因子。研究发现,在接受CCT治疗的4168名mPCa患者中,449名(11.3%)进行

Intens Care Med:重症监护患者精神疾病分析

由此可见,ICU与住院后精神疾病诊断风险略有增加相关,当考虑入院原因时往往不再明显。机械通气或ICU停留时间较长的患者后续发生精神疾病的风险可能较高。

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