Novel coronavirus pneumonia: cancer patients are more at risk of new crown pneumonia and have poorer prognosis.

Author: Yu Xiaocheng, according to a study published online on February 14 in the Lancet Oncology, cancer patients may have a higher risk of covid-19 than patients without cancer, and the prognosis is poor, which reminds doctors in time that they should pay more attention to cancer patients under the condition of rapid deterioration Https://doi.org/10.1016/s1470-2045 (20) 30096-6 is different from SARS and mers The death caused by covid-19 is more due to multiple organ dysfunction syndrome, non respiratory failure, which may be attributed to the widespread distribution of ACE-2 as a new coronavirus receptor in multiple organs Cancer patients are more likely to be infected than non cancer patients because of their systemic immunosuppression caused by cancer treatment (such as chemotherapy or surgery) The research team led by Professor He Jianxing from the First Affiliated Hospital of Guangzhou Medical University established a prospective cohort to monitor covid-19 cases nationwide As of January 31, 2020, 2007 confirmed cases from 575 hospitals in 31 provincial administrative regions were collected and analyzed, and 417 cases were excluded due to insufficient history records Of the 1590 cases, 18 (1%, 95%CI0.61 - 1.65) had a history of cancer, and seemed to be higher than the incidence rate of cancer in the whole Chinese population (0.29%), of which lung cancer was the most common type (5/18, 28%) In addition to 2 patients with unknown treatment status, 4 (25%) received chemotherapy or surgery in the past month, while the remaining 12 (75%) were cancer survivors who received routine follow-up after the initial resection Patients with cancer were older (mean 63.1 vs 48.7 years), had a history of smoking (22% vs 7%), had multiple dyspnea (47% vs 23%), and had more severe CT findings (94% vs 71%) than those without cancer, but there was no significant difference in gender, other baseline symptoms, other comorbidity or X-ray baseline severity Most importantly, cancer patients were at a higher risk of serious events (admission to an ICU requiring invasive ventilation or death) (39% vs 8%, P = 0.0003) In addition, patients who received chemotherapy or surgery in the past month had a higher risk of clinical serious events (75%) than those who did not (43%) After adjusting for age, smoking history and other risk factors, these possibilities were further confirmed by logistic regression model (or5.34, 95% ci1.80-16.18; P = 0.0026) Cancer history is the highest risk of serious events In cancer patients, old age was the only risk factor for serious events (or1.43, 95% ci0.97-2.12; P = 0.072) In addition, Cox regression model was used to assess the time-dependent risk of serious events, and cancer patients deteriorated faster than those without cancer (median time of serious events was 13 days vs 43 days, P < 0.0001; after age adjustment, the risk rate was 3.56, 95% CI 1.65-7.69) No serious events in cancer patients, cancer survivors and cancer patients (a) and the risk of serious events in cancer patients and cancer patients (b) Finally, the researchers put forward three strategies for cancer patients in the crisis of covid-19 and the occurrence of serious infectious diseases in the future: first, in the epidemic areas, we should consider delaying adjuvant chemotherapy or selective surgery to treat stable cancer; second, we should establish stricter personal protection regulations for cancer patients or cancer survivors; third, when cancer patients are infected with sars-cov-2 We should strengthen the monitoring or treatment, especially for the elderly or other patients with complications Reference: [1] cancer patients in sars-cov-2 infection: a nationwide analysis in China