感染SARS-CoV-2造成的COVID-19會發生急性呼吸窘迫症(ARDS),患者需要轉入加護病房治療,某些病患甚至會死亡。目前已知60歲以上以及免疫功能低下的族群容易被感染,但癌症病患的風險有多高,至今還沒有明確的報告。

根據武漢大學中南醫院的研究,1524位腫瘤科住院病患中有0.79%確診為COVID-19,相對同期武漢一般民眾確診率是0.37%;其中,非小細胞肺癌(NSCLC)病患確診率又高於其他病患,尤其是60歲以上者。

癌症病患確診COVID-19的症狀似乎也比一般民眾更嚴重。一篇也是來自武漢的報告指出,在所分析的28位罹患COVID-19的癌症病患中,有四分之一是肺癌患者、超過一半變成重症,需要呼吸器治療、35.7%有致命的併發症,死亡率達28.6%。大多數的死亡原因是ARDS。與重症相關的危險因子包括:14天內接受癌症治療,以及胸部電腦斷層上有實質樣變化。而一般民眾重症的比例約4.7%,死亡率約2.3%。

上述的結果呼應中國來自575間醫院、2007位罹患COVID-19的病例大規模調查分析。作者認為,癌症病患更容易罹患COVID-19,進展成重症的風險也較高。因此,在此大流行期間,呼籲腫瘤科醫師在安排病患治療及追蹤時要更留意權衡利弊。

(財團法人國家衛生研究院 齊嘉鈺醫師摘要整理)

Infection with SARS-CoV-2, resulting in coronavirus disease (COVID-19), can lead to acute respiratory distress syndrome (ARDS) requiring admission to an intensive care unit (ICU), and sometimes death, in a subset of patients. So far, we know that individuals ≥60 years of age and/or those with a supressed immune system are particularly vulnerable to COVID-19, although how these risks apply to patients with cancer remains unclear. Several reports are beginning to emerge.

First, patients with cancer seem to be more likely to be diagnosed with COVID-19. Among 1,524 patients admitted to the Department of Radiation and Medical Oncology of Zhongnan Hospital of Wuhan University, 12 (0.79%) had COVID-19, versus 0.37% of the general population of Wuhan during the same period of time (OR 2.31, 95% CI 1.89–3.02). In the same study, patients with non-small-cell lung cancer (NSCLC) seemed to have a higher incidence of COVID-19, especially those >60 years of age (4.3% versus 1.8% in those aged ≤60 years with NSCLC).

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Author:Peter Sidaway   
原文連結:https://www.nature.com/articles/s41571-020-0366-2