严重和/或长期的COVID-19在血液病中:在奥米克朗时代之前和期间的临床影响
Akinao Okamoto1, Masahiro Yoshida2, Senji Kasahara3
1Department of Hematology, Fujita Health University School of Medicine, Toyoake, Japan.
Frontiers in oncology
|November 21, 2025
概括
欧米克朗变种在血液恶性瘤患者中降低了COVID-19的严重程度和死亡率,但整体存活率保持不变. 高龄和先前的班达穆斯丁暴露是不良结果的关键风险因素.
科学领域:
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
- 在瘤学瘤学.
背景情况:
- 欧米克朗变异对血液恶性瘤患者COVID-19严重性的影响尚不清楚.
- 需要进行流行病学调查,以澄清Omicron在这个脆弱人群中的影响.
研究的目的:
- 为了在患有血液病的患者中比较COVID-19在pre-Omicron和Omicron期间的结果.
- 在这个群体中确定严重疾病和死亡率的独立预后因素.
主要方法:
- 一项多中心回顾性队列研究包括1,023名在日本被诊断患有COVID-19的血液病患者 (2020年1月-2023年1月).
- 结果 (严重/持续的疾病,COVID-19相关的死亡率,整体存活率) 在前欧米克朗和欧米克朗期间进行了比较.
- 多变量分析确定了独立的不良预后因素.
主要成果:
- 与Omicron前时期相比,Omicron期间的严重/长期疾病率 (26.0%与48.0%) 和COVID-19相关死亡率 (5.0%与15.0%) 显著降低.
- 总体存活率在两个时期之间没有显著差异 (92.0%和84.0%).
- 年龄≥60岁,男性性别和先前的bendamustine暴露是不良结果的独立预测因素;抗CD38抗体治疗与死亡率有关.
结论:
- 血液病患者的Omicron变体感染与减少疾病严重性和死亡率有关,但没有改善整体存活率.
- 高龄和先前的达穆斯丁暴露是不良结果的重要风险因素.
- 严格的感染预防和及时的COVID-19管理对于高风险的血液恶性瘤患者至关重要.
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