乳腺癌患者新型冠状病毒感染后的临床症状:基于患者自报告结局的多中心横断面调查研究

Clinical symptoms of female breast cancer patients with COVID-19:a multi-center

目的探讨女性乳腺癌患者新型冠状病毒肺炎(COVID-19)奥密克戎变异株感染后的临床症状和心理状况,为临床诊治和疾病防控提供参考。方法本研究为多中心横断面调查研究,纳人了来自全国5个省份10家医院的乳腺专科中心的1150例女性乳腺癌患者。全部患者均在COVID-19感染28d内。由西安交通大学第一附属医院统一制作调查表,并以微信问卷形式发送,患者根据内容自行填写,实施时间为2022年12月27日8点至2022年12月29日18点,研究内容包括COVID-19疫苗接种、感染症状、诊断和治疗及患者心理状况等。采用广泛性焦虑量表(GAD-7)评估乳腺癌患者的焦虑程度。结果1150例患者中,未进行疫苗接种者高达35.39%(407/1150),而COVID-19感染接触史者占44.87%(516/1150)。患者感染症状以轻型为主(95.39%,1097/1150)。初始症状常见为发热(47.30%,544/1150)、咽痛(21.57%248/1150)、肌肉酸痛/关节痛(9.04%,104/1150)。乳腺癌患者GAD-7得分为48(31,44)分。34.35%(395/1150)患者出现不同程度的焦虑,而65.04%(748/1150)患者感到一定程度恐慌,其中,61.63%(461/748)患者害怕疾病复发或转移,51.01%(389/748)患者害怕影响家人健康,35.70%(267/748)患者害怕误治疗。结论COVID-19感染的女性乳腺癌患者症状以轻型为主,但是未进行疫苗接种者及心理状况不佳者比例均较高,后续需要加强对患者的COVID-19疫苗接种、心理疏导和健康科普。

Objective To investigate the clinical symptoms and psychological status of female breast cancer patients infected by the Omicron variants of corona virus disease 2019(COVID-19),and provide a reference for clinical diagnosis,treatment,prevention and control of this disease.Methods This study was a multicenter cross-sectional study that included 1150 female breast cancer patients from the breast disease centers of 10 hospitals in 5 provinces in China.All patients were within 28 days after Omicron infection.The questionnaire was produced by the First Affiliated Hospital of Xi'an Jiaotong University and sent to the patients by WeChat.The patients filled in the questionnaire by themselves,which was regarded as patient-reported outcome(PRO)measures.The implementation time was from 8 o'clock on December 27,2022 to 18 o'clock on December 29,2022.The survey focused on the COVID-19 vaccination,infection symptoms,diagnosis and treatment,and psychological status of patients.The Generalized Anxiety Disorder-7(GAD-7)scale was used to assess the level of anxiety in breast cancer patients.Results In 1150 female breast cancer infected by COVID-19,35.39%(407/1150)had not been vaccinated against COVID-19,44.87%(516/1150)had contact history of COVID-19,and 95.39%(1097/1150)showed mild symptoms.According to the frequency,the top three symptoms were fever(47.30%,544/1150),pharyngalgia(21.57%,248/1150)and muscular soreness or arthralgia(9.04%,104/1150).Furthermore,GAD-7 score was 48(31,44)and 34.35%(395/1150)showed anxiety to some extent,while 65.04%(748/1150)had panic disorder.The reasons were listed as follow:fear of disease recurrence or metastasis[61.63%(461/748)],concern about health of family members[51.01%(389/748)]and fear of treatment delay[35.70%(267/748)].Conclusion 1Most of female breast cancer patients with COVID-19 show mild symptoms,but the proportion of patients who have not been vaccinated and the proportion of patients with poor psychological status are high.It is necessary to strengthen COVID-19 vaccination,psychological counseling and health education for breast cancer patients.