What are the predictors of in-hospital mortality in cancer patients with COVID-19?

The highly contagious novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which caused coronavirus disease 2019 (COVID-19), was first detected in Wuhan, China. SARS-CoV-2 quickly spread around the world and was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. It has impacted the social, economic, and medical sectors of the world.

COVID-19 has been observed to cause severe illness in certain groups, including the elderly and those with underlying medical conditions such as cancer. A cancer patient has been reported to be more susceptible to her COVID-19 infection than the general population. Several previous studies have reported that COVID-19 infection may increase the risk of death and serious illness in cancer patients compared to the general population.

Since the beginning of the pandemic, emergency departments (EDs) have played a critical role in identifying and early isolation of infected patients. However, treating cancer patients with COVID-19 from ED is a difficult decision. This is due to the enormous burden of the virus on the healthcare system, the life-threatening nature of cancer, and the uncertainty regarding its impact on the outcome of infection.

new research in pro swan We aimed to analyze variables associated with in-hospital mortality in COVID-19-positive cancer patients referred to the ED.

About research

The study enrolled adult cancer patients who tested positive for COVID-19 and were referred to the ED at the American University of Beirut Medical Center (AUBMC) between February 21, 2020 and February 21, 2021. bottom. Patient demographics, cancer history and treatment, medical history information, smoking, comorbidities, length of stay in ED, management of ED, vitals at triage, procedure status, laboratory panel, and ICU admission requirements are all included. were collected from patients with

Investigation result

As a result, 89 patients were included in the study, whose mean age was 66 years. Most of the patients were observed to be male with solid tumors. More than half of them had metastases. Hypertension was reported to be the main comorbidity in patients, followed by cardiovascular disease, dyslipidemia, and diabetes mellitus. Half the patient was reported to be a smoker, and he received chemotherapy within 1 month of presentation to the ED. He is reported to have died in his third of patients admitted to the ICU.Most patients reported tachycardia, but a low rate of 40.4% oxygen saturation in triage.

Treatment of COVID-19 cancer patients includes anticoagulants, antibiotics, steroids, remdesivir, convalescent plasma, tocilizumab, or ivermectin. Very few patients were treated with vasopressors. It was reported that 33.7% of his patients had respiratory complications, 7.9% had cardiovascular complications, and 15.7% had septic shock. 28.1% of patients reported the need for endotracheal intubation, and 8 required dialysis. The average length of hospital stay was 30.7 days. In addition, most patients with liquid tumors were observed to be men with moderate to severe renal disease.

Results reported no significant differences in the presence of comorbidities, smoking status, age, and gender between deceased COVID-19 cancer patients and those who did not. Mortality was observed to be higher in patients who received chemotherapy within 1 month of ED onset, as well as in patients with a history of congestive heart failure (CHF). In addition, we observed that the patient who had tachypnea at triage was four times more likely to be associated with mortality than her.

In addition, patients who died were admitted to the ICU more frequently, were on ventilators, were treated more with vasopressors, received more treatment with more blood and platelet transfusions, and received more bariktinib. were observed to be treated with more steroids and with more tocilizumab. They were also observed to have higher levels of C-reactive protein (CRP) and procalcitonin.It was also observed that patients who died had a higher frequency of complications than those who did not die. .

Therefore, the current study shows that COVID-19 patients with ED with elevated CRP and/or PCT levels, a history of CHF, tachypnea, and/or receive chemotherapy within 1 month are at risk of death. indicates that it may be associated with higher This research will help frontline healthcare improve patient risk stratification and guide the decision-making process. This will help provide the best medical care to these highly vulnerable patient groups.

Limitations

This study has certain limitations. First, the study sample size was small. Second, the study was retrospective in nature. Third, the study was conducted at a single institution. Fourth, the evolving nature of the virus, improved treatment strategies, and vaccine deployment may affect the results.Fifth, the patient’s BMI and other laboratory values ​​cannot be analyzed in this study. was.