Omicron大流行期间肿瘤患者新型冠状病毒感染情况调查

Incidence of COVID⁃19 in Patients with Tumor During the Omicron Pandemic

目的 调查Omicron变异株大流行期间肿瘤患者发生新型冠状病毒(下文简称“新冠”)感染的情况。方法 2022年12月25日至2023年1月25日,通过问卷星平台以电子问卷的方式收集恶性肿瘤患者(包括既往于北京协和医院肿瘤内科就诊及于北京协和医院肿瘤内科进修医生所在当地医院肿瘤内科就诊的患者)接种新冠疫苗、调查期间(自2022年12月9日至问卷调查时)感染新冠、临床症状、感染后抗肿瘤治疗等相关信息,并进行统计学分析。结果 共发放调查问卷270份,回收有效问卷265份,有效回收率为98.1%。265例恶性肿瘤患者中,接种新冠疫苗170例(64.2%),带瘤生存158例(59.6%),感染新冠时或调查期间正在抗肿瘤治疗216例(81.5%);感染新冠210例(79.2%),其中发生新冠肺炎9例(4.3%),因新冠肺炎住院治疗3例(1.4%),无重症及死亡病例。新冠感染者中,205例(97.6%)出现新冠相关症状,其中以发热最为常见(72.9%),呼吸道症状以咳嗽(64.8%)、咳痰(50.5%)为主。新冠感染者与未感染者在性别、年龄、肿瘤类型、有/无基础疾病、是/否接种新冠疫苗、是/否正在抗肿瘤治疗方面均无显著差异(P均>0.05)。新冠感染者中,疫苗接种≥3剂者新冠肺炎发生率显著低于未接种者(1.1%比9.9%,P=0.025)。截至问卷调查时,88例患者于新冠感染后已开启抗肿瘤治疗,其中与感染前相比,感染后抗肿瘤治疗不良反应更严重12例(13.6%),症状相近64例(72.7%),症状更轻微12例(13.6%)。感染新冠前后抗肿瘤治疗不良反应变化与感染后开启抗肿瘤治疗时机无明显相关(P=0.938),而与感染后抗肿瘤治疗方式具有一定相关性(P=0.003)。结论 Omicron变异株大流行期间肿瘤患者对新冠普遍易感,几乎所有感染者均出现了相关临床症状,极少数发生新冠肺炎。接种≥3剂疫苗可能对新冠肺炎具有预防作用。多数肿瘤患者感染新冠后抗肿瘤治疗的不良反应较感染前无明显加重。

Objective To investigate the incidence of COVID-19 in patients with tumor during the pan-demic of Omicron variant strains.Methods From December 25,2022 to January 25,2023,through the questionnaire star platform in the form of electronic questionnaire,we collected information about COVID-19 vaccine,COVID-19 infection and clinical symptoms,and post-infection anti-tumor therapy of patients with ma-lignant tumors(including patients who previously visited the oncology department of Peking Union Medical Col-lege Hospital and the oncology department of the local hospital where the trainee doctors of the oncology depart-ment of Peking Union Medical College Hospital are located)during the survey period(from December 9,2022 to the time of questionnaire survey)and performed statistical analysis.Results A total of 270 questionnaires were sent out,of which 265 valid questionnaires were recovered(the effective questionnaire rate was 981%).Among the 265 patients with malignant tumors,170(642%)patients received COVID-19 vaccine,158(596%)patients were alive with tumor,and 216 patients(815%)were receiving antitumor therapy at the time of COVID-19 infection or during the investigation.In 210 cases(792%),patients were infected with COVID-19.Among them,9 cases(43%)developed COVID-19 pneumonia and 3 cases(14%)were hospi-talized due to COVID-19,and there were no severe or fatal cases.Among the infected patients,205(976%)patients showed symptoms related to the COVID-19,among which fever was the most common(729%)symp-tom,and cough(648%)and sputum(505%)were the main respiratory symptoms.There were no significant differences in gender,age,tumor type,whether they had underlying diseases,whether they were vaccinated against COVID-19,and whether they were treated with anti-tumor therapy between COVID-19 infected and un-infected patients(all P>005).Among the infected patients,the incidence of pneumonia in those who received≥3 doses of vaccine was significantly lower than that in those who did not receive vaccine(11%vs 99%,P=0025).At the time of questionnaire survey,88 patients started antitumor therapy after COVID-19 infec-tion.Compared to infection before COVID-19,12 patients(136%)had more serious adverse anti-tumor reac-tions after COVID-19 infection,63 patients(727%)had similar symptoms,and 12 patients(136%)had milder symptoms.There was no significant correlation between the adverse reactions of anti-tumor therapy before and after infection and the timing of initiation of anti-tumor therapy after infection(P=0938),but there was a certain correlation with anti-tumor therapy after infection(P=0003).Conclusions During the pandemic period of Omicron variant,tumor patients were generally susceptible to COVID-19.Almost all infected patients showed related clinical symptoms,but very few patients developed pneumonia.Vaccination with≥3 doses of vaccine may be protective against pneumonia.The adverse reactions of anti-tumor therapy in most cancer pa-tients after infection with COVID-19 were not significantly worse than those before infection.