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Войти в исследования COVID-19 in Patients With Gynecologic Cancer: A Report From the COVID-19 and Cancer Consortium.
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Brown Alaina J, Hsu Chih-Yuan, Mohsin Aleenah, Prescott Lauren S, Beeghly Alicia, Ruiz-Garcia Erika, Vilar-Compte Diana, García-Gordillo José Antonio, Hwang Clara, Hijaz Miriana, Buekers Thomas, Singh Sunny R K, Wise-Draper Trisha M, Ferrara Elizabeth K, McKay Rana R, Ajmera Archana, Mariano Melissa, Bhatt Padmanabh, Nagaraj Gayathri, Puc Matthew, Cosin Jonathan A, Bashir Babar, Russell Karen, Halabi Susan, McManus Hannah, Accordino Melissa K, Mavromatis Blanche H, Joshi Monika, Polimera Hyma V, Del Prete Salvatore A, Rose Suzanne J, Subbiah Suki, Faller Bryan A, Mansoor Abdul Hai, Eid Marc, Mishra Sanjay, O'Cearbhaill Roisin E, Crispens Marta A, Shyr Yu, Warner Jeremy L
Аннотация
METHODS: Gynecologic cancer patients with SARS-CoV-2 infection were identified from the international COVID-19 and Cancer Consortium registry. We estimated odds ratios (ORs) for associations with severity of COVID-19 outcomes. Multivariable models included adjustment for age, race, cancer status, and time period of COVID-19 diagnosis.
RESULTS: Of 920 patients, 438 patients (48%) had endometrial, 249 (27%) had ovarian, 198 (22%) had cervical, and 44 (5%) had vulvar/vaginal cancers. Most were from the United States (86%) and non-Hispanic White (48%). Median age was 62 years (IQR, 52-71). When diagnosed with COVID-19, 457 (49%) patients were in remission and 343 (37%) had active disease. Outcomes included hospitalization in 452 patients (49%), intensive care unit admittance in 107 patients (12%), mechanical ventilation in 70 patients (8%), and death within 30 days of testing positive for SARS-CoV-2 in 91 patients (10%). In multivariable models, increasing age (adjusted OR, 1.35 [95% CI, 1.23 to 1.49]) and non-Hispanic Black race (adjusted OR, 1.75 [95% CI, 1.24 to 2.48]) were associated with increased COVID-19 severity, as were cardiac (adjusted OR, 1.85 [95% CI, 1.36 to 2.52]), pulmonary (adjusted OR, 1.58 [95% CI, 1.12 to 2.22]), and renal (adjusted OR, 2.18 [95% CI, 1.48 to 3.19]) comorbidities. Patients in remission <5 years had decreased COVID-19 severity (adjusted OR, 0.60 [95% CI, 0.42 to 0.87]). Other cancer characteristics associated with increased severity included progression (adjusted OR, 2.91 [95% CI, 1.92 to 4.40]), stage (adjusted OR, 1.57 [95% CI, 1.11 to 2.22]), and metastatic disease (adjusted OR, 1.60 [95% CI, 1.10 to 2.34]).
CONCLUSION: Patients with gynecologic cancer experience significant morbidity and mortality related to infection with SARS-CoV-2. Age, race, cancer status, comorbidities, and COVID-19 complications were associated with more severe COVID-19 outcomes.