PDF(Pubmed)
Abstract：
BACKGROUND: Thymic epithelial tumors (TETs) are rare neoplasms often associated with immune-related disorders. Patients with Good\'s syndrome (GS), an adult-acquired TET-related immunodeficiency, are at a high risk of mortality due to infectious diseases. This study aims to examine COVID-19 occurrence and severity in TET patients, with or without GS.
METHODS: Clinical records of TET patients referred to the Regional Coordinating Center for Rare Tumors of Campania Region were retrospectively collected. During the observation period, elapsing from March 2020 to April 2023, the following data were collected: occurrence of SARS-CoV-2 infection; COVID-19 severity, according to the National Institute of Health (NIH) illness categories; COVID-19 treatment. COVID-19 occurrence and severity were assessed in the overall population and correlated with the presence of GS and/or other immune-related dysregulations.
RESULTS: Overall, 47 TET patients were included in the study; 27 of these (57.4%) had GS. All participants had received a full cycle of mRNA vaccine for SARS-CoV2., Thirty-one patients (66.0%) experienced COVID-19, of whom 18 (58.0%) had previously received a diagnosis of GS. No significant association of GS and/or other immune-related dysregulations with SARS-CoV-2 infection occurrence was detected (Fisher\'s exact test p = 1 and p = 0.3587, respectively). Among patients with GS, 8 (45.0%) reported a COVID-19 severity score of ≥ 3; whereas, only 1 of the 13 patients without GS (7.7%) had a severity score of ≥ 3. The correlation between presence of GS and COVID-19 severity (score 1 or 2 vs. ≥ 3) was statistically significant (p = 0.0448). No statistically significant association between COVID-19 severity and other immune-related syndromes were found (p = 1). Of note, all the hospitalized patients for NIH 4 and 5 COVID-19 had GS.
CONCLUSIONS: Our data suggest that TET patients, especially those with GS, require a careful multidisciplinary monitoring for SARS-CoV-2 infection, in order to establish tailored treatments and prophylactic protocols.
METHODS: Clinical records of TET patients referred to the Regional Coordinating Center for Rare Tumors of Campania Region were retrospectively collected. During the observation period, elapsing from March 2020 to April 2023, the following data were collected: occurrence of SARS-CoV-2 infection; COVID-19 severity, according to the National Institute of Health (NIH) illness categories; COVID-19 treatment. COVID-19 occurrence and severity were assessed in the overall population and correlated with the presence of GS and/or other immune-related dysregulations.
RESULTS: Overall, 47 TET patients were included in the study; 27 of these (57.4%) had GS. All participants had received a full cycle of mRNA vaccine for SARS-CoV2., Thirty-one patients (66.0%) experienced COVID-19, of whom 18 (58.0%) had previously received a diagnosis of GS. No significant association of GS and/or other immune-related dysregulations with SARS-CoV-2 infection occurrence was detected (Fisher\'s exact test p = 1 and p = 0.3587, respectively). Among patients with GS, 8 (45.0%) reported a COVID-19 severity score of ≥ 3; whereas, only 1 of the 13 patients without GS (7.7%) had a severity score of ≥ 3. The correlation between presence of GS and COVID-19 severity (score 1 or 2 vs. ≥ 3) was statistically significant (p = 0.0448). No statistically significant association between COVID-19 severity and other immune-related syndromes were found (p = 1). Of note, all the hospitalized patients for NIH 4 and 5 COVID-19 had GS.
CONCLUSIONS: Our data suggest that TET patients, especially those with GS, require a careful multidisciplinary monitoring for SARS-CoV-2 infection, in order to establish tailored treatments and prophylactic protocols.
摘要：
背景：胸腺上皮肿瘤（TET）是罕见的肿瘤，通常与免疫相关疾病有关。患有良好综合征（GS）的患者，成人获得性TET相关免疫缺陷，因传染病而死亡的风险很高。这项研究旨在检查TET患者的COVID-19发生率和严重程度，有或没有GS
方法：回顾性收集转诊到坎帕尼亚地区罕见肿瘤区域协调中心的TET患者的临床记录。在观察期间,从2020年3月到2023年4月，收集了以下数据：SARS-CoV-2感染的发生；COVID-19的严重程度，根据美国国立卫生研究院（NIH）的疾病类别；COVID-19治疗。在总体人群中评估了COVID-19的发生和严重程度，并与GS和/或其他免疫相关失调的存在相关。
结果：总体而言，47名TET患者被纳入研究；其中27名（57.4%）患有GS。所有参与者都接受了SARS-CoV2的mRNA疫苗的完整周期。,31例患者（66.0％）经历了COVID-19，其中18例（58.0％）以前曾被诊断为GS。未检测到GS和/或其他免疫相关失调与SARS-CoV-2感染发生的显着关联（分别为Fisher精确检验p=1和p=0.3587）。GS患者中,8人（45.0%）报告COVID-19严重程度评分≥3；而，无GS的13例患者中只有1例(7.7%)的严重程度评分≥3.GS的存在与COVID-19严重程度之间的相关性(评分1或2与≥3）有统计学意义（p=0.0448）。在COVID-19的严重程度和其他免疫相关综合征之间没有发现统计学上的显著关联(p=1)。值得注意的是，所有NIH4和5COVID-19的住院患者均患有GS。
结论：我们的数据表明TET患者，尤其是那些有GS的，需要对SARS-CoV-2感染进行仔细的多学科监测，以建立量身定制的治疗和预防方案。
方法：回顾性收集转诊到坎帕尼亚地区罕见肿瘤区域协调中心的TET患者的临床记录。在观察期间,从2020年3月到2023年4月，收集了以下数据：SARS-CoV-2感染的发生；COVID-19的严重程度，根据美国国立卫生研究院（NIH）的疾病类别；COVID-19治疗。在总体人群中评估了COVID-19的发生和严重程度，并与GS和/或其他免疫相关失调的存在相关。
结果：总体而言，47名TET患者被纳入研究；其中27名（57.4%）患有GS。所有参与者都接受了SARS-CoV2的mRNA疫苗的完整周期。,31例患者（66.0％）经历了COVID-19，其中18例（58.0％）以前曾被诊断为GS。未检测到GS和/或其他免疫相关失调与SARS-CoV-2感染发生的显着关联（分别为Fisher精确检验p=1和p=0.3587）。GS患者中,8人（45.0%）报告COVID-19严重程度评分≥3；而，无GS的13例患者中只有1例(7.7%)的严重程度评分≥3.GS的存在与COVID-19严重程度之间的相关性(评分1或2与≥3）有统计学意义（p=0.0448）。在COVID-19的严重程度和其他免疫相关综合征之间没有发现统计学上的显著关联(p=1)。值得注意的是，所有NIH4和5COVID-19的住院患者均患有GS。
结论：我们的数据表明TET患者，尤其是那些有GS的，需要对SARS-CoV-2感染进行仔细的多学科监测，以建立量身定制的治疗和预防方案。
