Clinical characteristics and outcomes among critically ill patients with cancer and COVID-19-related acute respiratory failure
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 comp...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-024-02850-z |
| _version_ | 1797350171095334912 |
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| author | Ying-Ting Liao Hsiao-Chin Shen Jhong-Ru Huang Chuan-Yen Sun Hung-Jui Ko Chih-Jung Chang Yuh-Min Chen Jia-Yih Feng Wei-Chih Chen Kuang-Yao Yang |
| author_facet | Ying-Ting Liao Hsiao-Chin Shen Jhong-Ru Huang Chuan-Yen Sun Hung-Jui Ko Chih-Jung Chang Yuh-Min Chen Jia-Yih Feng Wei-Chih Chen Kuang-Yao Yang |
| author_sort | Ying-Ting Liao |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-08T12:41:52Z |
| format | Article |
| id | doaj.art-f3a093a3c1144827a082d957f1731a4a |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-03-08T12:41:52Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-f3a093a3c1144827a082d957f1731a4a2024-01-21T12:08:39ZengBMCBMC Pulmonary Medicine1471-24662024-01-0124111110.1186/s12890-024-02850-zClinical characteristics and outcomes among critically ill patients with cancer and COVID-19-related acute respiratory failureYing-Ting Liao0Hsiao-Chin Shen1Jhong-Ru Huang2Chuan-Yen Sun3Hung-Jui Ko4Chih-Jung Chang5Yuh-Min Chen6Jia-Yih Feng7Wei-Chih Chen8Kuang-Yao Yang9Department of Chest Medicine, Taipei Veterans General HospitalDepartment of Chest Medicine, Taipei Veterans General HospitalDepartment of Chest Medicine, Taipei Veterans General HospitalDepartment of Chest Medicine, Taipei Veterans General HospitalDepartment of Chest Medicine, Taipei Veterans General HospitalDepartment of Chest Medicine, Taipei Veterans General HospitalDepartment of Chest Medicine, Taipei Veterans General HospitalDepartment of Chest Medicine, Taipei Veterans General HospitalDepartment of Chest Medicine, Taipei Veterans General HospitalDepartment of Chest Medicine, Taipei Veterans General HospitalAbstract 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.https://doi.org/10.1186/s12890-024-02850-zAcute respiratory failureCoronavirus disease 2019 (COVID-19)MalignancyVasopressorInflammatory marker |
| spellingShingle | Ying-Ting Liao Hsiao-Chin Shen Jhong-Ru Huang Chuan-Yen Sun Hung-Jui Ko Chih-Jung Chang Yuh-Min Chen Jia-Yih Feng Wei-Chih Chen Kuang-Yao Yang Clinical characteristics and outcomes among critically ill patients with cancer and COVID-19-related acute respiratory failure BMC Pulmonary Medicine Acute respiratory failure Coronavirus disease 2019 (COVID-19) Malignancy Vasopressor Inflammatory marker |
| title | Clinical characteristics and outcomes among critically ill patients with cancer and COVID-19-related acute respiratory failure |
| title_full | Clinical characteristics and outcomes among critically ill patients with cancer and COVID-19-related acute respiratory failure |
| title_fullStr | Clinical characteristics and outcomes among critically ill patients with cancer and COVID-19-related acute respiratory failure |
| title_full_unstemmed | Clinical characteristics and outcomes among critically ill patients with cancer and COVID-19-related acute respiratory failure |
| title_short | Clinical characteristics and outcomes among critically ill patients with cancer and COVID-19-related acute respiratory failure |
| title_sort | clinical characteristics and outcomes among critically ill patients with cancer and covid 19 related acute respiratory failure |
| topic | Acute respiratory failure Coronavirus disease 2019 (COVID-19) Malignancy Vasopressor Inflammatory marker |
| url | https://doi.org/10.1186/s12890-024-02850-z |
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