Coinfections in Patients With Cancer and COVID-19: A COVID-19 and Cancer Consortium (CCC19) Study

被引：8

作者：

Satyanarayana, Gowri ^{[1
]}

Enriquez, Kyle T. ^{[1
]}

Sun, Tianyi ^{[1
]}

Klein, Elizabeth J. ^{[2
,3
]}

Abidi, Maheen ^{[4
]}

Advani, Shailesh M. ^{[5
]}

Awosika, Joy ^{[6
]}

Bakouny, Ziad ^{[7
]}

Bashir, Babar ^{[8
]}

Berg, Stephanie ^{[9
]}

Bernardes, Marilia ^{[10
]}

Egan, Pamela C. ^{[2
,3
]}

Elkrief, Arielle ^{[11
]}

Feldman, Lawrence E. ^{[12
]}

Friese, Christopher R. ^{[13
]}

Goel, Shipra ^{[14
]}

Gomez, Cyndi Gonzalez ^{[13
]}

Grant, Keith L. ^{[15
]}

Griffiths, Elizabeth A. ^{[14
]}

Gulati, Shuchi ^{[6
]}

Gupta, Shilpa ^{[16
]}

Hwang, Clara ^{[17
]}

Jain, Jayanshu ^{[18
]}

Jani, Chinmay ^{[19
]}

Kaltsas, Anna ^{[10
]}

Kasi, Anup ^{[18
]}

Khan, Hina ^{[2
,3
]}

Knox, Natalie ^{[20
]}

Koshkin, Vadim S. ^{[21
]}

Kwon, Daniel H. ^{[21
]}

Labaki, Chris ^{[7
]}

Lyman, Gary H. ^{[22
,23
]}

McKay, Rana R. ^{[24
]}

McNair, Christopher ^{[8
]}

Nagaraj, Gayathri ^{[25
]}

Nakasone, Elizabeth S. ^{[22
,23
]}

Nguyen, Ryan ^{[12
]}

Nonato, Taylor K. ^{[24
]}

Olszewski, Adam J. ^{[2
,3
]}

Panagiotou, Orestis A. ^{[2
,3
]}

Puc, Matthew ^{[26
]}

Razavi, Pedram ^{[24
]}

Robilotti, Elizabeth, V ^{[10
]}

Santos-Dutra, Miriam ^{[11
]}

Schmidt, Andrew L. ^{[7
]}

Shah, Dimpy P. ^{[27
]}

Shah, Sumit A. ^{[28
]}

Vieira, Kendra ^{[2
,3
]}

Weissmann, Lisa B. ^{[18
]}

Wise-Draper, Trisha M. ^{[6
]}

机构：

[1] Vanderbilt Univ, Med Ctr, Nashville, TN USA

[2] Brown Univ, Warren Alpert Med Sch, Providence, RI 02903 USA

[3] Lifespan Canc Inst, Providence, RI USA

[4] Univ Colorado, Anschutz Med Campus, Aurora, CO USA

[5] Georgetown Univ, Sch Med, Dept Oncol, Canc Prevent & Control, Washington, DC USA

[6] Univ Cincinnati, Canc Ctr, Cincinnati, OH USA

[7] Dana Farber Canc Inst, Boston, MA 02115 USA

[8] Thomas Jefferson Univ, Sidney Kimmel Canc Ctr, Philadelphia, PA 19107 USA

[9] Loyola Univ Med Ctr, Cardinal Bernardin Canc Ctr, Maywood, IL 60153 USA

[10] Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA

[11] McGill Univ, Hlth Ctr, Montreal, PQ, Canada

[12] Univ Illinois, Hosp & Hlth Sci Syst, Chicago, IL USA

[13] Univ Michigan, Rogel Canc Ctr, Ann Arbor, MI 48109 USA

[14] Roswell Pk Comprehens Canc Ctr, Buffalo, NY USA

[15] Hartford HealthCare Canc Inst, Hartford, CT USA

[16] Cleveland Clin, Cleveland, OH 44106 USA

[17] Henry Ford Hosp, Henry Ford Canc Inst, Detroit, MI 48202 USA

[18] Univ Kansas, Canc Ctr, Overland Pk, KS USA

[19] Mt Auburn Hosp, Cambridge, MA USA

[20] Loyola Univ, Stritch Sch Med, Maywood, IL 60153 USA

[21] Univ Calif San Francisco, Helen Diller Family Comprehens Canc Ctr, San Francisco, CA 94143 USA

[22] Fred Hutchinson Canc Res Ctr, Washington, DC USA

[23] Univ Washington, Seattle, WA 98195 USA

[24] Univ Calif San Diego, Moores Canc Ctr, La Jolla, CA 92093 USA

[25] Loma Linda Univ, Canc Ctr, Loma Linda, CA 92350 USA

[26] Virtua Hlth, Mt Holly, NJ USA

[27] UT Hlth San Antonio MD Anderson Canc Ctr, Mays Canc Ctr, San Antonio, TX USA

[28] Stanford Univ, Stanford Canc Inst, Stanford, CA 94305 USA

来源：

OPEN FORUM INFECTIOUS DISEASES | 2022年 / 9卷 / 03期

基金：

美国国家卫生研究院;

关键词：

bacterial infections; CAPA (COVID-19-associated pulmonary aspergillosis); COVID-19; mucormycoses; viral infections; DISEASE; IMPACT;

D O I：

10.1093/ofid/ofac037

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background The frequency of coinfections and their association with outcomes have not been adequately studied among patients with cancer and coronavirus disease 2019 (COVID-19), a high-risk group for coinfection. Methods We included adult (>= 18 years) patients with active or prior hematologic or invasive solid malignancies and laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection, using data from the COVID-19 and Cancer Consortium (CCC19, NCT04354701). We captured coinfections within +/- 2 weeks from diagnosis of COVID-19, identified factors cross-sectionally associated with risk of coinfection, and quantified the association of coinfections with 30-day mortality. Results Among 8765 patients (hospitalized or not; median age, 65 years; 47.4% male), 16.6% developed coinfections: 12.1% bacterial, 2.1% viral, 0.9% fungal. An additional 6.4% only had clinical diagnosis of a coinfection. The adjusted risk of any coinfection was positively associated with age >50 years, male sex, cardiovascular, pulmonary, and renal comorbidities, diabetes, hematologic malignancy, multiple malignancies, Eastern Cooperative Oncology Group Performance Status, progressing cancer, recent cytotoxic chemotherapy, and baseline corticosteroids; the adjusted risk of superinfection was positively associated with tocilizumab administration. Among hospitalized patients, high neutrophil count and C-reactive protein were positively associated with bacterial coinfection risk, and high or low neutrophil count with fungal coinfection risk. Adjusted mortality rates were significantly higher among patients with bacterial (odds ratio [OR], 1.61; 95% CI, 1.33-1.95) and fungal (OR, 2.20; 95% CI, 1.28-3.76) coinfections. Conclusions Viral and fungal coinfections are infrequent among patients with cancer and COVID-19, with the latter associated with very high mortality rates. Clinical and laboratory parameters can be used to guide early empiric antimicrobial therapy, which may improve clinical outcomes.

引用

页数：10

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