Cancer-Related Characteristics Associated With Invasive Mechanical Ventilation or In-Hospital Mortality in Patients With COVID-19 Admitted to ICU: A Cohort Multicenter Study

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 i...

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Autores principales: Pedro Caruso, Renato Scarsi Testa, Isabel Cristina Lima Freitas, Ana Paula Agnolon Praça, Valdelis Novis Okamoto, Pauliane Vieira Santana, Ramon Teixeira Costa, Alexandre Melo Kawasaki, Renata Rego Lins Fumis, Wilber Antonio Pino Illanes, Eduardo Leite Vieira Costa, Thais Dias Midega, Thiago Domingos Correa, Fabrício Rodrigo Torres de Carvalho, Juliana Carvalho Ferreira
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Publicado: Frontiers Media S.A. 2021
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spelling oai:doaj.org-article:6897d7774e07452c8de5d0c94666622c2021-12-01T14:53:28ZCancer-Related Characteristics Associated With Invasive Mechanical Ventilation or In-Hospital Mortality in Patients With COVID-19 Admitted to ICU: A Cohort Multicenter Study2234-943X10.3389/fonc.2021.746431https://doaj.org/article/6897d7774e07452c8de5d0c94666622c2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.746431/fullhttps://doaj.org/toc/2234-943XBackgroundCoexistence 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.Pedro CarusoPedro CarusoRenato Scarsi TestaIsabel Cristina Lima FreitasAna Paula Agnolon PraçaValdelis Novis OkamotoPauliane Vieira SantanaRamon Teixeira CostaAlexandre Melo KawasakiAlexandre Melo KawasakiRenata Rego Lins FumisWilber Antonio Pino IllanesEduardo Leite Vieira CostaEduardo Leite Vieira CostaThais Dias MidegaThiago Domingos CorreaFabrício Rodrigo Torres de CarvalhoFabrício Rodrigo Torres de CarvalhoJuliana Carvalho FerreiraJuliana Carvalho FerreiraFrontiers Media S.A.articlecancerCOVID-19intensive care unitneoplasmshospital mortalityrespirationNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution DOAJ
collection DOAJ
language EN
topic cancer
COVID-19
intensive care unit
neoplasms
hospital mortality
respiration
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
spellingShingle cancer
COVID-19
intensive care unit
neoplasms
hospital mortality
respiration
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
RC254-282
Pedro Caruso
Pedro Caruso
Renato Scarsi Testa
Isabel Cristina Lima Freitas
Ana Paula Agnolon Praça
Valdelis Novis Okamoto
Pauliane Vieira Santana
Ramon Teixeira Costa
Alexandre Melo Kawasaki
Alexandre Melo Kawasaki
Renata Rego Lins Fumis
Wilber Antonio Pino Illanes
Eduardo Leite Vieira Costa
Eduardo Leite Vieira Costa
Thais Dias Midega
Thiago Domingos Correa
Fabrício Rodrigo Torres de Carvalho
Fabrício Rodrigo Torres de Carvalho
Juliana Carvalho Ferreira
Juliana Carvalho Ferreira
Cancer-Related Characteristics Associated With Invasive Mechanical Ventilation or In-Hospital Mortality in Patients With COVID-19 Admitted to ICU: A Cohort Multicenter Study
description 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.
format article
author Pedro Caruso
Pedro Caruso
Renato Scarsi Testa
Isabel Cristina Lima Freitas
Ana Paula Agnolon Praça
Valdelis Novis Okamoto
Pauliane Vieira Santana
Ramon Teixeira Costa
Alexandre Melo Kawasaki
Alexandre Melo Kawasaki
Renata Rego Lins Fumis
Wilber Antonio Pino Illanes
Eduardo Leite Vieira Costa
Eduardo Leite Vieira Costa
Thais Dias Midega
Thiago Domingos Correa
Fabrício Rodrigo Torres de Carvalho
Fabrício Rodrigo Torres de Carvalho
Juliana Carvalho Ferreira
Juliana Carvalho Ferreira
author_facet Pedro Caruso
Pedro Caruso
Renato Scarsi Testa
Isabel Cristina Lima Freitas
Ana Paula Agnolon Praça
Valdelis Novis Okamoto
Pauliane Vieira Santana
Ramon Teixeira Costa
Alexandre Melo Kawasaki
Alexandre Melo Kawasaki
Renata Rego Lins Fumis
Wilber Antonio Pino Illanes
Eduardo Leite Vieira Costa
Eduardo Leite Vieira Costa
Thais Dias Midega
Thiago Domingos Correa
Fabrício Rodrigo Torres de Carvalho
Fabrício Rodrigo Torres de Carvalho
Juliana Carvalho Ferreira
Juliana Carvalho Ferreira
author_sort Pedro Caruso
title Cancer-Related Characteristics Associated With Invasive Mechanical Ventilation or In-Hospital Mortality in Patients With COVID-19 Admitted to ICU: A Cohort Multicenter Study
title_short Cancer-Related Characteristics Associated With Invasive Mechanical Ventilation or In-Hospital Mortality in Patients With COVID-19 Admitted to ICU: A Cohort Multicenter Study
title_full Cancer-Related Characteristics Associated With Invasive Mechanical Ventilation or In-Hospital Mortality in Patients With COVID-19 Admitted to ICU: A Cohort Multicenter Study
title_fullStr Cancer-Related Characteristics Associated With Invasive Mechanical Ventilation or In-Hospital Mortality in Patients With COVID-19 Admitted to ICU: A Cohort Multicenter Study
title_full_unstemmed Cancer-Related Characteristics Associated With Invasive Mechanical Ventilation or In-Hospital Mortality in Patients With COVID-19 Admitted to ICU: A Cohort Multicenter Study
title_sort cancer-related characteristics associated with invasive mechanical ventilation or in-hospital mortality in patients with covid-19 admitted to icu: a cohort multicenter study
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/6897d7774e07452c8de5d0c94666622c
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