Clinical characteristics and outcomes among critically ill patients with cancer and COVID-19-related acute respiratory failure.
BMC Pulm Med
; 24(1): 34, 2024 Jan 15.
Article
en En
| MEDLINE
| ID: mdl-38225613
ABSTRACT
BACKGROUND:
Coronavirus disease 2019 (COVID-19) has affected individuals worldwide, and patients with cancer are particularly vulnerable to COVID-19-related severe illness, respiratory failure, and mortality. The relationship between COVID-19 and cancer remains a critical concern, and a comprehensive investigation of the factors affecting survival among patients with cancer who develop COVID-19-related respiratory failure is warranted. We aim to compare the characteristics and outcomes of COVID-19-related acute respiratory failure in patients with and without underlying cancer, while analyzing factors affecting in-hospital survival among cancer patients.METHODS:
We conducted a retrospective observational study at Taipei Veterans General Hospital in Taiwan from May to September 2022, a period during which the omicron variant of the severe acute respiratory syndrome coronavirus 2 was circulating. Eligible patients had COVID-19 and acute respiratory failure. Clinical data, demographic information, disease severity markers, treatment details, and outcomes were collected and analyzed.RESULTS:
Of the 215 enrolled critically ill patients with COVID-19, 65 had cancer. The patients with cancer were younger and had lower absolute lymphocyte counts, higher ferritin and lactate dehydrogenase (LDH) concentrations, and increased vasopressor use compared with those without cancer. The patients with cancer also received more COVID-19 specific treatments but had higher in-hospital mortality rate (61.5% vs 36%, P = 0.002) and longer viral shedding (13 vs 10 days, P = 0.007) than those without cancer did. Smoking [odds ratio (OR) 5.804, 95% confidence interval (CI) 1.847-39.746], elevated LDH (OR 1.004, 95% CI 1.001-1.012), vasopressor use (OR 5.437, 95% CI 1.202-24.593), and new renal replacement therapy (OR 3.523, 95% CI 1.203-61.108) were independent predictors of in-hospital mortality among patients with cancer and respiratory failure.CONCLUSION:
Critically ill patients with cancer experiencing COVID-19-related acute respiratory failure present unique clinical features and worse clinical outcomes compared with those without cancer. Smoking, elevated LDH, vasopressor use, and new renal replacement therapy were risk factors for in-hospital mortality in these patients.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Síndrome de Dificultad Respiratoria
/
Insuficiencia Respiratoria
/
COVID-19
/
Neoplasias
Tipo de estudio:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
BMC Pulm Med
Año:
2024
Tipo del documento:
Article
País de afiliación:
Taiwán