患有严重急性呼吸系统综合征冠状病毒2型活动性癌症和已有心血管疾病的患者的结果。

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Brijesh Patel, Scott A Chapman, Jake T Neumann, Aayush Visaria, Oluwabunmi Ogungbe, Sijin Wen, Maryam Khodaverdi, Priyal Makwana, Jasvinder A Singh, George Sokos
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引用次数: 0

摘要

目的:确定急性SARS-CoV-2感染对伴有活动性癌症和心血管疾病患者的影响。方法:研究人员从2020年1月1日至2022年7月22日期间的国家COVID队列协作(N3C)数据库中提取并分析数据。他们只包括急性严重急性呼吸系统综合征冠状病毒2型感染的患者,定义为指数住院前21天和住院后5天通过PCR检测呈阳性。活动性癌症被定义为指数入院后30天内最后一次服用癌症药物。“Cardioonc”组由心血管疾病和活动性癌症患者组成。该队列被分为四组:(1)CVD(-),(2)CVD( +), (3) Cardioonc(-)和(4)( +), 其中(-)或( +) 表示急性严重急性呼吸系统综合征冠状病毒2型感染状态。该研究的主要结果是主要心血管不良事件(MACE),包括急性中风、急性心力衰竭、心肌梗死或全因死亡率。研究人员分析了疫情不同阶段的结果,并对其他MACE成分和作为竞争事件的死亡进行了竞争风险分析。结果:该研究分析了418306名患者,其中74%、10%、15.7%和0.3%患有CVD(-)( +), Cardioonc(-)( +), 分别地The Cardioonc( +) 在疫情的所有四个阶段中,该组的MACE事件最高。与CVD(-)相比,Cardioonc( +) 组MACE的比值比为1.66。然而,在奥密克戎时代,心脏病患者发生MACE的风险在统计学上显著增加( +) 与CVD(-)相比。竞争风险分析显示,心血管疾病患者的全因死亡率明显较高( +) 分组并限制其他MACE事件的发生。当研究人员确定特定的癌症类型时,癌症结肠癌患者的MACE较高。这些发现强调了改进管理策略和进一步研究的必要性,以更好地了解新冠肺炎大流行期间病毒对弱势人群的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Outcomes of patients with active cancers and pre-existing cardiovascular diseases infected with SARS-CoV-2.

Outcomes of patients with active cancers and pre-existing cardiovascular diseases infected with SARS-CoV-2.

Outcomes of patients with active cancers and pre-existing cardiovascular diseases infected with SARS-CoV-2.

Outcomes of patients with active cancers and pre-existing cardiovascular diseases infected with SARS-CoV-2.

Objective: To determine the impact of acute SARS-CoV-2 infection on patient with concomitant active cancer and CVD.

Methods: The researchers extracted and analyzed data from the National COVID Cohort Collaborative (N3C) database between January 1, 2020, and July 22, 2022. They included only patients with acute SARS-CoV-2 infection, defined as a positive test by PCR 21 days before and 5 days after the day of index hospitalization. Active cancers were defined as last cancer drug administered within 30 days of index admission. The "Cardioonc" group consisted of patients with CVD and active cancers. The cohort was divided into four groups: (1) CVD (-), (2) CVD ( +), (3) Cardioonc (-), and (4) Cardioonc ( +), where (-) or ( +) denotes acute SARS-CoV-2 infection status. The primary outcome of the study was major adverse cardiovascular events (MACE), including acute stroke, acute heart failure, myocardial infarction, or all-cause mortality. The researchers analyzed the outcomes by different phases of the pandemic and performed competing-risk analysis for other MACE components and death as a competing event.

Results: The study analyzed 418,306 patients, of which 74%, 10%, 15.7%, and 0.3% had CVD (-), CVD ( +), Cardioonc (-), and Cardioonc ( +), respectively. The Cardioonc ( +) group had the highest MACE events in all four phases of the pandemic. Compared to CVD (-), the Cardioonc ( +) group had an odds ratio of 1.66 for MACE. However, during the Omicron era, there was a statistically significant increased risk for MACE in the Cardioonc ( +) group compared to CVD (-). Competing risk analysis showed that all-cause mortality was significantly higher in the Cardioonc ( +) group and limited other MACE events from occurring. When the researchers identified specific cancer types, patients with colon cancer had higher MACE.

Conclusion: In conclusion, the study found that patients with both CVD and active cancer suffered relatively worse outcomes when they had acute SARS-CoV-2 infection during early and alpha surges in the United States. These findings highlight the need for improved management strategies and further research to better understand the impact of the virus on vulnerable populations during the COVID-19 pandemic.

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来源期刊
Cardio-oncology
Cardio-oncology Medicine-Cardiology and Cardiovascular Medicine
CiteScore
5.00
自引率
3.00%
发文量
17
审稿时长
7 weeks
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