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Cancer-Related Characteristics Associated With Invasive Mechanical Ventilation or In-Hospital Mortality in Patients
Pedro Caruso1,2, Renato Scarsi Testa1, Isabel Cristina Lima Freitas1
1Intensive Care Unit, AC Camargo Cancer Center, Sao Paulo, Brazil.
Frontiers in Oncology
|December 17, 2021
Summary
Poor performance status in cancer patients with COVID-19 predicts in-hospital mortality but not mechanical ventilation needs. Other cancer characteristics did not impact outcomes in the intensive care unit (ICU).
Area of Science:
- Oncology
- Infectious Diseases
- Critical Care Medicine
Background:
- The coexistence of cancer and COVID-19 is linked to poorer patient outcomes.
- Previous studies on cancer characteristics influencing COVID-19 prognosis have yielded conflicting findings.
- This study aimed to clarify cancer-related factors affecting mechanical ventilation or mortality in critically ill COVID-19 patients with cancer.
Purpose of the Study:
- To investigate the association between specific cancer-related characteristics and the need for invasive mechanical ventilation in COVID-19 patients admitted to the ICU.
- To evaluate the relationship between cancer-related characteristics and in-hospital mortality among COVID-19 patients in the ICU.
Main Methods:
- A multicenter cohort study was conducted involving adult patients with active cancer admitted to the ICU for COVID-19.
- Seven cancer-related variables (cancer status, type, metastasis, recent chemotherapy/immunotherapy, lung tumor, performance status) were analyzed using multilevel logistic regression.
- Confounding factors were identified and controlled for using directed acyclic graphs.
Main Results:
- The study included 274 patients; 176 (64.2%) required invasive mechanical ventilation, with no cancer-related characteristic showing an association.
- In-hospital mortality was observed in 155 patients (56.6%).
- Poor performance status (ECOG scores 2-4) was significantly associated with increased in-hospital mortality (OR 3.54-3.40), while cancer status, type, metastasis, lung cancer, and recent treatments were not.
Conclusions:
- Among cancer patients with COVID-19 in the ICU, poor performance status is a predictor of in-hospital mortality.
- Performance status did not correlate with the need for mechanical ventilation.
- Key cancer-related factors such as cancer type, metastatic status, lung cancer, and recent treatments did not influence mechanical ventilation use or mortality.
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