COVID-19 Enfeksiyonu Sonrası Kanser Hastalarında Uzun Süreli Sağkalım: İnflamatuar İndekslerin Ve Aşılama Durumunun Prognostik Değeri

Öz

Coronavirus Disease 2019 (COVID-19) enfeksiyonuna maruz kalan kanser hastalarının sağkalım sonuçları, enfeksiyon sonrası tedaviye yeniden başlama süresi ve malignitelerinin seyri hakkındaki veriler kısıtlıdır. Bu retrospektif çalışmada, Nisan 2020 ile Ekim 2023 tarihleri arasında merkezimizde COVID-19 nedeniyle yatarak tedavi gören 128 kanser hastası değerlendirilmiştir. Hastaların %39,8'i kadın, %60,2'si erkekti. Akut enfeksiyon sürecinde metastatik akciğer tutulumu olan hastaların, olmayanlara göre 3,34 kat daha yüksek ölüm riski taşıdığı saptanmıştır. Post-COVID sağkalım kohortunda yapılan çok değişkenli analizde; daha genç yaş, daha yüksek hemoglobin düzeyi, daha yüksek sistemik inflamatuvar indeks, daha düşük pan-immün inflamasyon değeri ve aktif kanser bulunmaması daha uzun sağkalım ile ilişkili bulunmuştur. Ayrıca aşı tipine bağlı sağkalım farklılıkları gözlenmiştir; ancak bu bulguların belirli aşı tiplerinin yüksek riskli hastalara öncelikli olarak uygulanması gibi karıştırıcı faktörleri yansıtma olasılığı nedeniyle doğrudan nedensel bir ilişkiyi göstermediği ve bu nedenle temkinli yorumlanması gerektiği düşünülmektedir. Çalışmanın ayırt edici özelliği olan uzun süreli takip sonucunda, progresyon gösteren hastalarda tedavi gecikmeleri yaygın görülse de bu gecikmelerin genel sağkalım üzerinde istatistiksel olarak anlamlı bir fark yaratmadığı belirlenmiştir.

Anahtar Kelimeler

• COVID-19
• Neoplasms
• RNA Vaccines
• Inflammation
• Time-to-treatment
• Post-acute COVID-19 Syndrome

Destekleyen Kurum

Bu araştırma için herhangi bir dış destek veya fon alınmamıştır

Etik Beyan

İnsan katılımcıların yer aldığı bu geriye dönük (retrospektif) çalışmada gerçekleştirilen tüm prosedürler, kurumsal araştırma komitesinin etik standartlarına, 1964 Helsinki Deklarasyonu’na ve deklarasyonun daha sonraki değişikliklerine uygun olarak yürütülmüştür. Çalışma protokolü, Bursa Uludağ Üniversitesi Tıp Fakültesi Etik Kurulu tarafından onaylanmıştır (Onay No: 2023-9/27, Tarih: 25 Nisan 2023). Çalışmanın retrospektif doğası gereği, bilgilendirilmiş onam alma zorunluluğu etik kurul tarafından kaldırılmıştır

Teşekkür

Yazarlar, örneklem büyüklüğü hesaplamasındaki değerli yardımlarından dolayı Dr. İlker Ercan'a (Biyoistatistik Anabilim Dalı, Uludağ Üniversitesi, Bursa, Türkiye) teşekkürlerini sunarlar

Long-Term Survival of Cancer Patients Following COVID-19 Infection: Prognostic Value of Inflammatory Indices and Vaccination Status

Öz

The survival outcomes of cancer patients exposed to Coronavirus Disease 2019 (COVID-19), the duration required to resume oncological treatment, and the subsequent course of their malignancy remain areas with limited data. This retrospective study evaluated 128 cancer patients hospitalized for COVID-19 treatment between April 2020 and October 2023. Of the cohort, 39.8% were women and 60.2% were men. Findings revealed that patients with metastatic lung involvement faced a 3.34-fold increased risk of death during the acute infection. In the post-COVID survival cohort, multivariate analysis indicated that younger age, higher hemoglobin levels, higher systemic inflammatory index, lower pan-immune inflammation value, and absence of active cancer were associated with longer survival. Additionally, vaccine-related survival differences were observed; however, these findings should be interpreted cautiously as they likely reflect confounding factors such as prioritizing high-risk patients for certain vaccine types rather than a direct causal relationship. Notably, while treatment delays were common among patients with disease progression, these delays did not result in a statistically significant difference in overall survival during the long-term follow-up.

Anahtar Kelimeler

• COVID-19
• Neoplasms
• RNA Vaccines
• Inflammation
• Time-to-treatment
• Post-acute COVID-19 Syndrome

Destekleyen Kurum

The authors declare that this research received no external funding.

Etik Beyan

All procedures performed in this retrospective study involving human participants were conducted in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. The study protocol was approved by the Ethics Committee of Bursa Uludağ University Faculty of Medicine (Approval No. 2023-9/27, dated April 25, 2023). The requirement for informed consent was waived by the ethics committee due to the retrospective nature of the study.

Teşekkür

Authors would like to thank Dr. İlker Ercan (Department of Biostatistics, Uludag University, Bursa, Turkey) for the precious help with sample size calculation.

Kaynakça

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