背景:COVID-19在2020年初开始传播,这是法国医院将肺癌(LC)患者纳入前瞻性流行病学队列KBP-2020-CPHG的确切年份。这为研究COVID-19发病率提供了独特的机会,生存风险因素,和总体预后。
方法:在接种疫苗之前收集COVID数据。比较了临床特征(COVID与非COVID),发病率比率是根据临床特征计算的,评估了生存期(1个月和3个月),并研究了COVID-19对队列总体预后的影响.
结果:2020年,8999例肺癌患者中有285例被诊断为COVID-19。诊断主要基于PCR检测(86.3%)。年发病率为8.3%(95%CI[7.4,9.3]);在以前的吸烟者和患有鳞状细胞癌或小细胞癌的患者中,它高于患有腺癌的患者。在PS评分≥2和0-1以及III-IV期与I-II期的患者中。接受化疗或免疫治疗的患者的发病率降低。64.9%的患者因COVID-19住院。COVID-19患者在1个月和3个月时死亡的危险因素是年龄,LC级,PS得分。多因素分析显示COVID-19对LC患者死亡率的主要预后影响(风险比:4.12,95%CI[3.42,4.97],p<0.001)。
结论:这项前瞻性研究证明了LC患者中COVID-19的高发病率,并确定了COVID-19的危险因素:吸烟状况,组织学,PS,和舞台。COVID-19对肺癌死亡率的影响似乎很大。
BACKGROUND: COVID-19 started to spread early in 2020, the precise year that lung cancer (LC) patients were recruited into the prospective epidemiological cohort KBP-2020-CPHG in French hospitals. This provides a unique opportunity to study COVID-19 incidence, survival risk factors, and overall prognosis.
METHODS: COVID data was collected before vaccination was made available. Clinical characteristics were compared (COVID vs non-COVID), incidence rate ratios were calculated based on clinical characteristics, survival (1 and 3 months) was estimated and the impact of COVID-19 on the overall prognosis of the cohort was studied.
RESULTS: In 2020, 285 out of 8,999 lung cancer patients were diagnosed with COVID-19. Diagnosis was mainly based on PCR tests (86.3 %). The annual incidence was 8.3 % (95 % CI [7.4, 9.3]); it was higher in former smokers and patients with squamous cell carcinoma or small cell carcinoma than in those with adenocarcinoma, in those with a PS score ≥2 versus 0-1, and with
stages III-IV versus
stages I-II. The incidence was reduced in patients who received chemotherapy or immunotherapy. 64.9 % of patients were hospitalized due to COVID-19. Risk factors for death at 1 and 3 months in COVID-19 patients were age, LC stage, and PS score. Multivariate analysis showed a major prognostic impact of COVID-19 on mortality of LC patients (hazard ratio: 4.12, 95 % CI [3.42, 4.97], p < 0.001).
CONCLUSIONS: This prospective study demonstrated the high incidence of COVID-19 in LC patients and identified as risk factors for COVID-19: smoking status, histology, PS, and stage. The impact of COVID-19 on lung cancer mortality appears major.