Abstract
BackgroundCoexistence of cancer and COVID-19 is associated with worse outcomes. However, the studies on cancer-related characteristics associated with worse COVID-19 outcomes have shown controversial results. The objective of the study was to evaluate cancer-related characteristics associated with invasive mechanical ventilation use or in-hospital mortality in patients with COVID-19 admitted to intensive care unit (ICU).MethodsWe designed a cohort multicenter study including adults with active cancer admitted to ICU due to COVID-19. Seven cancer-related characteristics (cancer status, type of cancer, metastasis occurrence, recent chemotherapy, recent immunotherapy, lung tumor, and performance status) were introduced in a multilevel logistic regression model as first-level variables and hospital was introduced as second-level variable (random effect). Confounders were identified using directed acyclic graphs.ResultsWe included 274 patients. Required to undergo invasive mechanical ventilation were 176 patients (64.2%) and none of the cancer-related characteristics were associated with mechanical ventilation use. Approximately 155 patients died in hospital (56.6%) and poor performance status, measured with the Eastern Cooperative Oncology Group (ECOG) score was associated with increased in-hospital mortality, with odds ratio = 3.54 (1.60–7.88, 95% CI) for ECOG =2 and odds ratio = 3.40 (1.60–7.22, 95% CI) for ECOG = 3 to 4. Cancer status, cancer type, metastatic tumor, lung cancer, and recent chemotherapy or immunotherapy were not associated with in-hospital mortality.ConclusionsIn patients with active cancer and COVID-19 admitted to ICU, poor performance status was associated with in-hospital mortality but not with mechanical ventilation use. Cancer status, cancer type, metastatic tumor, lung cancer, and recent chemotherapy or immunotherapy were not associated with invasive mechanical ventilation use or in-hospital mortality.
Highlights
It has been shown that patients with cancer are more susceptible to the disease caused by the new SARS-CoV-2 virus (COVID-19) [1, 2] and that the coexistence of cancer and COVID-19 is associated with worse outcomes, such as hospitalization, invasive mechanical ventilation (MV) use, intensive care unit (ICU) admission, and mortality [1,2,3,4,5]
We showed that poor performance status was associated with in-hospital mortality
In patients with active cancer admitted to ICU due to COVID19, a poor performance status is associated with increased inhospital mortality
Summary
It has been shown that patients with cancer are more susceptible to the disease caused by the new SARS-CoV-2 virus (COVID-19) [1, 2] and that the coexistence of cancer and COVID-19 is associated with worse outcomes, such as hospitalization, invasive mechanical ventilation (MV) use, intensive care unit (ICU) admission, and mortality [1,2,3,4,5]. The studies that evaluated the cancer-related characteristics associated with worse COVID-19 outcomes have shown controversial results. The studies on cancer-related characteristics associated with worse COVID-19 outcomes have shown controversial results. The objective of the study was to evaluate cancer-related characteristics associated with invasive mechanical ventilation use or inhospital mortality in patients with COVID-19 admitted to intensive care unit (ICU)
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