Characteristics and Outcomes of COVID-19 Cancer Patients Admitted to a Portuguese Intensive Care Unit: A Case-Control Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Patient Selection
2.2. Data Collection
2.3. Statistical Analysis
3. Results
3.1. Demographic and Clinical Characteristics
3.2. Clinical Presentation and Laboratorial and Radiological Findings
3.3. Treatment and Complications
3.4. Effect of Oncological Disease on Outcomes
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Univariate Logistic Regression | OR | 95% CI | p-Value a |
---|---|---|---|
Fever Dyspnea Cough Asthenia Dysgeusia Diarrhea Desaturation Abdominal pain Odynophagia Headache Myalgias Leukopenia Lymphopenia Anemia Thrombocytopenia Elevated CRP Elevated PCT Elevated LDH Elevated D-dimers Consolidation Ground-glass opacities Nodular pattern Respiratory dysfunction Cardiovascular dysfunction Liver dysfunction Renal dysfunction Hematological dysfunction CNS dysfunction Secondary infection Septic shock PTE | |||
1 0.574 0.322 0.799 1.558 1.558 2.074 1 0.482 0.482 0.171 2.812 0.768 3.868 1.302 1 1.544 1.302 0.871 2.750 0.286 1.071 1 1.414 0.756 1.544 0.724 0.866 1.569 1.518 0.310 | 0.355–2.817 0.203–1.623 0.064–9.081 0.214–2.982 0.240–10.091 0.240–10.091 0.178–24.228 0.060–16.791 0.041–5.632 0.041–5.632 0.919–1.571 0.499–15.857 0.184–3.206 1.260–11.860 0.312–5.436 0.339–2.953 0.535–4.452 0.312–5.436 0.311–2.440 0.610–12.407 0.046–1.780 0.061–18.820 0.389–2.974 0.449–4.507 0.268–2.135 0.535–4.452 0.237–2.213 0.303–2.481 0.533–4.161 0.538–4.284 0.030–3.166 | 1 0.295 0.650 0.738 0.642 0.642 0.561 1 0.561 0.561 0.119 0.241 0.717 0.018 0.717 1 0.422 0.717 0.793 0.188 0.180 0.962 1 0.558 0.598 0.422 0.571 0.788 0.414 0.431 0.325 |
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Characteristics of Matching | With Cancer—Case (n = 29) n (%) | Without Cancer—Control (n = 29) n (%) | p-Value |
---|---|---|---|
Age (years) Median (range) | 77 (63.5–80) | 74 (64.5–80.5) | 0.988 |
Male Sex | 17 (59%) | 17 (59%) | 1 |
Comorbidities Current or past smoker Overweight/obesity Arterial hypertension Diabetes mellitus Dyslipidemia Cardiovascular disease Respiratory disease Kidney disease | |||
11 (38%) 13 (45%) 19 (66%) 12 (41%) 11 (38%) 9 (31%) 9 (31%) 6 (21%) | 10 (34%) 14 (48%) 19 (66%) 14 (48%) 10 (34%) 11 (38%) 10 (34%) 6 (21%) | 0.785 0.792 1 0.792 0.785 0.783 0.780 1 |
Patient Characteristics | With Cancer—Case (n = 29) n (%) |
---|---|
Type of cancer Solid Hematological | |
23 (79.3%) | |
6 (20.7%) | |
Stage of solid malignancy I–III IV | 20 (87%) |
3 (13%) | |
Cancer classification according to ICD-10 Malignant cancer of digestive tract (C15–C26) Malignant cancer of respiratory and intrathoracic organs (C30–C39) Malignant cancer of bone and articular cartilage (C40–C41) Malignant cancer of soft tissue (C45–C49) Malignant cancer of breast (C50–C50) Malignant cancer of male genital tract (C60–C63) Malignant cancer of the urinary tract (C64–C68) Malignant cancer of central nervous system (C69–C72) Malignant cancer of thyroid and other endocrine glands (C73–C75) Leukemia (C81–C96) Lymphoma (C81–C96) Multiple myeloma (C81–C96) | |
3 (10.3%) 2 (6.9%) 1 (3.4%) 3 (10.3%) 4 (13.8%) 4 (13.8%) 4 (13.8%) 1 (3.4%) 1 (3.4%) 3 (10.3%) 2 (6.9%) 1 (3.4%) | |
Status of cancer Surveillance Active | 9 (31%) 20 (69%) |
Prior treatment Surgery Radiotherapy Chemotherapy Endocrine therapy Target therapy | 20 (69%) 8 (27.6%) 8 (27.6%) 6 (20.7%) 1 (3.4%) |
Patient Characteristics | With Cancer—Case (n = 29) n (%) | Without Cancer—Control (n = 29) n (%) | p-Value |
---|---|---|---|
Symptoms or signs at initial presentation Fever Dyspnea Cough Asthenia Dysgeusia Diarrhea Prostration Desaturation Abdominal pain Odynophagia Headache Myalgias | |||
13 (44.8%) 12 (41.4%) 10 (34.5%) 5 (17.2%) 3 (10.3%) 3 (10.3%) 2 (6.9%) 2 (6.9%) 1 (3.4%) 1 (3.4%) 1 (3.4%) 1 (3.4%) | 13 (44.8%) 16 (55.2%) 18 (62.1%) 6 (20.7%) 2 (6.9%) 2 (6.9%) - 1 (3.4%) 1 (3.4%) 2 (6.9%) 2 (6.9%) 5 (17.2%) | 1 0.431 0.650 0.738 0.640 0.640 - 0.553 1 0.553 0.553 0.194 | |
Analytical parameters at ICU admission Leukopenia a Lymphopenia b Anemia c Thrombocytopenia d Elevated CRP e Elevated PCT f Elevated LDH g Elevated D-dimers h | |||
5 (17.2%) 24 (82.8%) 22 (75.9%) 5 (17.2%) 19 (65.5%) 13 (44.8%) 25 (86.2%) 14 (48.3%) | 2 (6.9%) 25 (86.2%) 13 (44.8%) 4 (13.8%) 19 (65.5%) 10 (34.5%) 24 (82.8%) 15 (51.7%) | 0.423 0.717 0.031 0.717 1 0.592 0.717 0.793 | |
Findings on chest X-ray at ICU admission Unilateral Bilateral | 1 (3.4%) 28 (96.6%) | 2 (6.9%) 27 (93.1%) | 0.553 |
CT pattern at ICU admission Consolidation Ground-glass opacities Nodular pattern | 11/15 (73.3%) 10/15 (66.7%) 1/15 (6.7%) | 8/16 (50%) 16/16 (100%) 1/16 (6.3%) | 0.273 0.018 0.963 |
SAPS II at ICU admission SOFA at ICU admission | 44.24 ± 18.27 6 (2–8) | 34.31 ± 19.99 4 (2–9) | 0.067 0.396 |
Characteristics | With Cancer—Case (n = 29) n (%) | Without Cancer—Control (n = 29) n (%) | p-Value |
---|---|---|---|
Organs/Systems Dysfunction Respiratory Cardiovascular Liver Renal Hematological CNS | 29 (100%) 22 (75.9%) 12 (41.4%) 19 (65.5%) 8 (27.6%) 11 (38%) | 29 (100%) 20 (69%) 14 (48.3%) 16 (55.2%) 10 (34.5%) 12 (41.4%) | 1 0.770 0.792 0.592 0.777 0.914 |
Secondary Infection VAP CVC-associated infection | 20 (69%) 12 (60%) 1 (5%) | 17 (58.6%) 9 (52.9%) 1 (5.9%) | 0.414 |
Septic shock | 17 (58.6%) | 14 (48.3%) | 0.599 |
PTE | 1 (3.4%) | 3 (10.3%) | 0.300 |
Length of ICU stay (days) | 8 (3–23.50) | 9 (6–13.50) | 0.944 |
Variables | With Cancer—Case (n = 29) n (%) | Without Cancer—Control (n = 29) n (%) | p-Value |
---|---|---|---|
Oxygen therapy/ventilatory support at ICU admission Oxygen therapy HCM HFOT NIMV IMV | |||
11 (37.9%) 3 (10.3%) 8 (27.6%) 4 (13.8%) 14 (48.3%) | 23 (79.3%) 2 (6.9%) 21 (72.4%) 4 (13.8%) 2 (6.9%) | 0.186 1 0.002 | |
IMV need during all-length of ICU stay | 22 (75.9%) | 16 (55.2%) | 0.167 |
Days from ICU admission to IMV Total days on IMV | 2 (1–9) 12 (4.75–28.75) | 2 (1.75–2) 11 (7–14) | 0.685 0.871 |
Drug Therapy Corticosteroids Remdesivir Antimicrobial treatments Vasopressor support | 22 (75.9%) 5 (17.2%) 20 (69%) 20 (69%) | 29 (100%) 6 (20.7%) 16 (55.2%) 17 (58.6%) | 0.005 0.738 0.279 0.414 |
Prone positioning | 16 (55.2%) | 19 (65.5%) | 0.421 |
ECMO | 1 (3.4%) | 1 (3.4%) | 1 |
RRT | 2 (6.9%) | 1 (3.4%) | 0.998 |
Days from ICU admission and death | 8 (4–25.5) | 13 (7–18) | 0.299 |
Univariate Logistic Regression | OR | 95% CI | p-Value a |
---|---|---|---|
Death IMV need at ICU admission IMV need during all-length of ICU stay | 2.318 | 0.809–6.644 | 0.118 |
12.600 2.554 | 2.517–63.063 0.831–7.842 | 0.002 0.102 | |
Multivariate Logistic Regression | Adjusted OR b | 95% CI | p-Value a |
IMV need at ICU admission | 14.036 | 1.337–153.111 | 0.028 |
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Ranchor, R.; Pereira, N.; Medeiros, A.R.; Magalhães, M.; Marinho, A.; Araújo, A. Characteristics and Outcomes of COVID-19 Cancer Patients Admitted to a Portuguese Intensive Care Unit: A Case-Control Study. Cancers 2023, 15, 3264. https://doi.org/10.3390/cancers15123264
Ranchor R, Pereira N, Medeiros AR, Magalhães M, Marinho A, Araújo A. Characteristics and Outcomes of COVID-19 Cancer Patients Admitted to a Portuguese Intensive Care Unit: A Case-Control Study. Cancers. 2023; 15(12):3264. https://doi.org/10.3390/cancers15123264
Chicago/Turabian StyleRanchor, Ridhi, Nuno Pereira, Ana R. Medeiros, Manuel Magalhães, Aníbal Marinho, and António Araújo. 2023. "Characteristics and Outcomes of COVID-19 Cancer Patients Admitted to a Portuguese Intensive Care Unit: A Case-Control Study" Cancers 15, no. 12: 3264. https://doi.org/10.3390/cancers15123264
APA StyleRanchor, R., Pereira, N., Medeiros, A. R., Magalhães, M., Marinho, A., & Araújo, A. (2023). Characteristics and Outcomes of COVID-19 Cancer Patients Admitted to a Portuguese Intensive Care Unit: A Case-Control Study. Cancers, 15(12), 3264. https://doi.org/10.3390/cancers15123264