Frontiers in Oncology (Nov 2021)

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

  • 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

DOI
https://doi.org/10.3389/fonc.2021.746431
Journal volume & issue
Vol. 11

Abstract

Read online

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.

Keywords