Öz
Objective
New corona virus disease (COVID-19) is a respiratory
disease associated with high mortality that emerged
in December 2019. Individuals with preexisting health
conditions, such as heart disease, hypertension,
diabetes, and chronic obstructive pulmonary disease,
and those with weakened immune systems are at
increased risk for severe complications. Cancer
patients have been adversely affected by the pandemic,
both due to the disease itself and its treatments. The
aim of this study is to evaluate the impact of COVID 19
on mortality in cancer patients followed in the intensive
care unit (ICU).
Material and Method
We conducted a retrospective analysis of 275
COVID-19 patients who were admitted to the ICU
between January 2020 and April 2022. Among these
patients, 72 had a cancer diagnosis and were classified
into two groups: Group 1 (n=203) included patients
without cancer, and Group 2 (n=72) included patients
with cancer. We recorded age, gender, comorbidities,
PCR test results, laboratory parameters, APACHE2
and SOFA scores, duration of ICU stay, mechanical
ventilation requirement, and duration of mechanical
ventilation for all patients.
Results
Hypertension was significantly more common in Group
1 compared to Group 2 [97 (48%) and 24 (33%),
respectively); p<0.05]. Serum C-reactive protein
levels were significantly higher in Group 2 compared
to Group 1 [144 (0.5-480) and 112 (1.1-404) mg/L,
respectively; p<0.01]. Serum albumin, serum platelet
and hematocrit levels were significantly lower in Group
2 compared to Group 1 [respectively 2.7 ±0.4 and
2.9 ±1.3; p <0.01], [respectively; 173 (11-557) and
212 (14-624); p <0.01], [respectively; 31.4± 7.1 and
35.8±6.6; p <0.01]. Mortality ratio was significantly
lower in Group 2 compared to Group 1 [51 (71%) and
114 (56%), respectively; p=0.03].
Conclusions
Our results suggest that mortality in cancer patients
with COVID-19 who are admitted to the ICU is higher
than in those without cancer. Further studies are
needed to validate our results.
Anahtar Kelimeler
Kaynakça
- 1. Fang X, Li S, Yu H, Wang P, Zhang Y, Chen Z et al. Epidemiological, comorbidity factors with severity and prognosis of COVID- 19: a systematic review and meta-analysis. Aging. 2020 Jul 13;12(13):12493-12503. doi: 10.18632/aging.103579.
- 2. Zaoui N, Bachir N, Terki A, Boukabous A. Myocardite à COVID- 19 : « à propos d'une série monocentrique de 33 cas » [COVID-19 myocarditis : "About a monocentric series of 33 cases"]. Ann Cardiol Angeiol. 2022 Oct;71(4):219-222. French. doi: 10.1016/j.ancard.2022.08.004.
- 3. Gibson PG, Qin L, Puah SH. COVID-19 acute respiratory distress syndrome (ARDS): clinical features and differences from typical pre-COVID-19 ARDS. Med J Aust. 2020 Jul;213(2):54- 56.e1. doi: 10.5694/mja2.50674.
- 4. Iba T, Connors JM, Levy JH. The coagulopathy, endotheliopathy, and vasculitis of COVID-19. Inflamm Res. 2020 Dec;69(12):1181-1189. doi: 10.1007/s00011-020-01401-6.
- 5. Han X, Ye Q. Kidney involvement in COVID-19 and its treatments. J Med Virol. 2021 Mar;93(3):1387-1395. doi: 10.1002/jmv.26653.
- 6. Ejaz H, Alsrhani A, Zafar A, Javed H, Junaid K, Abdalla AE et al. COVID-19 and comorbidities: Deleterious impact on infected patients. J Infect Public Health. 2020 Dec;13(12):1833-1839. doi: 10.1016/j.jiph.2020.07.014.
- 7. Sidaway P. COVID-19 and cancer: what we know so far. Nat Rev Clin Oncol. 2020 Jun;17(6):336. doi: 10.1038/s41571-020- 0366-2.
- 8. Rucinska M, Nawrocki S. COVID-19 Pandemic: Impact on Cancer Patients. Int J Environ Res Public Health. 2022 Sep 30;19(19):12470. doi: 10.3390/ijerph191912470.
- 9. Cantini L, Mentrasti G, Russo GL, Signorelli D, Pasello G, Rijavec E et al. Evaluation of COVID-19 impact on DELAYing diagnostic- therapeutic pathways of lung cancer patients in Italy (COVID-DELAY study): fewer cases and higher stages from a real-world scenario. ESMO Open. 2022 Apr;7(2):100406. doi: 10.1016/j.esmoop.2022.100406.
- 10. İlgün AS, Özmen V. The Impact of the COVID-19 Pandemic on Breast Cancer Patients. Eur J Breast Health. 2021 Dec 30;18(1):85-90. doi: 10.4274/ejbh.galenos.2021.2021-11-5.
- 11. Moiseev S, Avdeev S, Brovko M, Akulkina L, Fomin V. Cancer in intensive care unit patients with COVID-19. J Infect. 2020 Aug;81(2):e124-e125. doi: 10.1016/j.jinf.2020.05.053.
- 12. Salunke AA, Nandy K, Pathak SK, Shah J, Kamani M, Kottakota V et al. Impact of COVID -19 in cancer patients on severity of disease and fatal outcomes: A systematic review and meta-analysis. Diabetes Metab Syndr. 2020 Sep-Oct;14(5):1431-1437. doi: 10.1016/j.dsx.2020.07.037.
- 13. Liu C, Zhao Y, Okwan-Duodu D, Basho R, Cui X. COVID-19 in cancer patients: risk, clinical features, and management. Cancer Biol Med. 2020 Aug 15;17(3):519-527. doi: 10.20892/j. issn.2095-3941.2020.0289.
- 14. Liang W, Guan W, Chen R, Wang W, Li J, Xu K et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020 Mar;21(3):335-337. doi: 10.1016/ S1470-2045(20)30096-6.
- 15. Zhang L, Zhu F, Xie L, Wang C, Wang J, Chen R, et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann Oncol. 2020 Jul;31(7):894-901. doi: 10.1016/j.annonc. 2020.03.296.
- 16. Erdal GS, Polat O, Erdem GU, Korkusuz R, Hindilerden F, Yilmaz M et al. The mortality rate of COVID-19 was high in cancer patients: a retrospective single-center study. Int J Clin Oncol. 2021 May;26(5):826-834. doi: 10.1007/s10147-021-01863-6.
- 17. Qu R, Ling Y, Zhang YH, Wei LY, Chen X, Li XM et al. Platelet- to-lymphocyte ratio is associated with prognosis in patients with coronavirus disease-19. J Med Virol. 2020 Sep;92(9):1533- 1541. doi: 10.1002/jmv.25767.
- 18. Yeoh CB, Lee KJ, Rieth EF, Mapes R, Tchoudovskaia AV, Fischer GW et al. COVID-19 in the Cancer Patient. Anesth Analg. 2020 Jul;131(1):16-23. doi: 10.1213/ ANE.0000000000004884.
- 19. Dai M, Liu D, Liu M, Zhou F, Li G, Chen Z, et al. Patients with Cancer Appear More Vulnerable to SARS-CoV-2: A Multicenter Study during the COVID-19 Outbreak. Cancer Discov. 2020 Jun;10(6):783-791. doi: 10.1158/2159-8290.CD-20-0422.
- 20. Yang F, Shi S, Zhu J, Shi J, Dai K, Chen X. Clinical characteristics and outcomes of cancer patients with COVID-19. J Med Virol. 2020 Oct;92(10):2067-2073. doi: 10.1002/jmv.25972.
- 21. Lin YC, Tsai YH, Huang CC, Hsu KH, Wang SW, Tsao TC et al. Outcome of lung cancer patients with acute respiratory failure requiring mechanical ventilation. Respir Med. 2004 Jan;98(1):43-51. doi: 10.1016/j.rmed.2003.07.009.
- 22. Englum BR, Prasad NK, Lake RE, Mayorga-Carlin M, Turner DJ, Siddiqui T et al. Impact of the COVID-19 pandemic on diagnosis of new cancers: A national multicenter study of the Veterans Affairs Healthcare System. Cancer. 2022 Mar 1;128(5):1048-1056. doi: 10.1002/cncr.34011.
- 23. Kuzuu K, Misawa N, Ashikari K, Kessoku T, Kato S, Hosono K et al. Gastrointestinal Cancer Stage at Diagnosis Before and During the COVID-19 Pandemic in Japan. JAMA Netw Open. 2021 Sep 1;4(9):e2126334. doi: 10.1001/jamanetworkopen. 2021.26334.
- 24. Burki TK. Cancer care in the time of COVID-19. Lancet Oncol. 2020 May;21(5):628. doi: 10.1016/S1470-2045(20)30201-1.
- 25. Grivas P, Khaki AR, Wise-Draper TM, French B, Hennessy C, Hsu CY et al. Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium. Ann Oncol. 2021 Jun;32(6):787-800. doi: 10.1016/j.annonc. 2021.02.024.
- 26. Mehta V, Goel S, Kabarriti R, Cole D, Goldfinger M, Acuna-Villaorduna A et al. Case Fatality Rate of Cancer Patients with COVID-19 in a New York Hospital System. Cancer Discov. 2020 Jul;10(7):935-941. doi: 10.1158/2159-8290.CD-20-0516.
- 27. Aboueshia M, Hussein MH, Attia AS, Swinford A, Miller P, Omar M et al. Cancer and COVID-19: analysis of patient outcomes. Future Oncol. 2021 Sep;17(26):3499-3510. doi: 10.2217/fon- 2021-0121.
- 28. Kuderer NM, Choueiri TK, Shah DP, Shyr Y, Rubinstein SM, Rivera DR et al. COVID-19 and Cancer Consortium. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. Lancet. 2020 Jun 20;395(10241):1907-1918. doi: 10.1016/S0140-6736(20)31187-9. Epub 2020 May 28. Erratum in: Lancet. 2020 Sep 12;396(10253):758.
Öz
Amaç
Yeni koronavirüs hastalığı (COVİD 19) Aralık 2019 yılında
ortaya çıkan mortalitesi yüksek bir solunum sistemi
hastalığıdır. Kalp hastalığı, hipertansiyon, diyabet
ve kronik obstrüktif akciğer hastalığı olan ve bağışıklık
sistemi zayıflamış kişiler, ciddi komplikasyonlar açısından
daha yüksek risk altındadır. Kanser hastaları hem
hastalığın hem de tedavilerinin getirdiği etkiler nedeniyle
pandemi sürecinden olumsuz etkilendi. Bu çalışmada
amacımız COVİD 19’ un yoğun bakımda takip
edilen kanser hastalarındaki mortalite üzerine etkisinin
değerlendirilmesidir.
Gereç ve Yöntem
Ocak 2020- Nisan 2022 yılları arasında yoğun bakımda
takip edilen 275 COVİD 19 hastası retrospektif
olarak incelendi. Bu hasta grubunda kanser tanısı
mevcut 72 hasta tespit edildi. Hastalar; grup 1 kanseri
olmayan hastalar(n=203), grup 2 kanseri olan hastalar
(n=72) olarak iki gruba ayrıldı. Tüm hastaların yaş,
cinsiyet, ek hastalık, PCR test pozitiflikleri, laboratuvar
parametreleri, APACHE II, SOFA skorları, yoğun bakım
kalış süresi, mekanik ventilatör gereksinimi, mekanik
ventilatör süreleri kaydedildi.
Bulgular
Hipertansiyon Grup 1 de Grup 2 ye kıyasla anlamlı
olarak daha yüksekti [(sırayla 97 (%48) ve 24 (%33);
p<0.05]. Serum C-reaktif protein (CRP) seviyeleri,
Grup 2 de Grup 1 ile karşılaştırıldığında anlamlı olarak
yüksekti [sırasıyla 144 (0.5-480) ve 112 (1.1-404)
mg/L; p <0.01]. Grup 2’ de serum albumin, serum platelet
ve hemotokrit düzeyleri Grup 1 ile karşılaştırıldığında
anlamlı olarak daha düşüktü [sırasıyla 2.7 ±0.4
ve 2.9 ±1.3; p <0.01], [sırasıyla 173 (11-557) ve 212
(14-624); p <0.01], [sırasıyla 31.4± 7.1 ve 35.8±6.6;
p <0.01]. Grup 1’de mortalite oranı grup 2 ye kıyasla
anlamlı olarak daha düşüktü [sırasıyla 114 (%56) ve
51 (%71); p:0.03].
Sonuç
Bu bulgular, yoğun bakımda takip edilen COVİD 19
olan kanser hastalarında mortalitenin, kanseri olmayan
hasta grubuna göre daha yüksek olduğunu göstermektedir.
Bu konuda yapılacak yeni çalışmalara
ihtiyaç duyulmaktadır.
Anahtar Kelimeler
Kaynakça
- 1. Fang X, Li S, Yu H, Wang P, Zhang Y, Chen Z et al. Epidemiological, comorbidity factors with severity and prognosis of COVID- 19: a systematic review and meta-analysis. Aging. 2020 Jul 13;12(13):12493-12503. doi: 10.18632/aging.103579.
- 2. Zaoui N, Bachir N, Terki A, Boukabous A. Myocardite à COVID- 19 : « à propos d'une série monocentrique de 33 cas » [COVID-19 myocarditis : "About a monocentric series of 33 cases"]. Ann Cardiol Angeiol. 2022 Oct;71(4):219-222. French. doi: 10.1016/j.ancard.2022.08.004.
- 3. Gibson PG, Qin L, Puah SH. COVID-19 acute respiratory distress syndrome (ARDS): clinical features and differences from typical pre-COVID-19 ARDS. Med J Aust. 2020 Jul;213(2):54- 56.e1. doi: 10.5694/mja2.50674.
- 4. Iba T, Connors JM, Levy JH. The coagulopathy, endotheliopathy, and vasculitis of COVID-19. Inflamm Res. 2020 Dec;69(12):1181-1189. doi: 10.1007/s00011-020-01401-6.
- 5. Han X, Ye Q. Kidney involvement in COVID-19 and its treatments. J Med Virol. 2021 Mar;93(3):1387-1395. doi: 10.1002/jmv.26653.
- 6. Ejaz H, Alsrhani A, Zafar A, Javed H, Junaid K, Abdalla AE et al. COVID-19 and comorbidities: Deleterious impact on infected patients. J Infect Public Health. 2020 Dec;13(12):1833-1839. doi: 10.1016/j.jiph.2020.07.014.
- 7. Sidaway P. COVID-19 and cancer: what we know so far. Nat Rev Clin Oncol. 2020 Jun;17(6):336. doi: 10.1038/s41571-020- 0366-2.
- 8. Rucinska M, Nawrocki S. COVID-19 Pandemic: Impact on Cancer Patients. Int J Environ Res Public Health. 2022 Sep 30;19(19):12470. doi: 10.3390/ijerph191912470.
- 9. Cantini L, Mentrasti G, Russo GL, Signorelli D, Pasello G, Rijavec E et al. Evaluation of COVID-19 impact on DELAYing diagnostic- therapeutic pathways of lung cancer patients in Italy (COVID-DELAY study): fewer cases and higher stages from a real-world scenario. ESMO Open. 2022 Apr;7(2):100406. doi: 10.1016/j.esmoop.2022.100406.
- 10. İlgün AS, Özmen V. The Impact of the COVID-19 Pandemic on Breast Cancer Patients. Eur J Breast Health. 2021 Dec 30;18(1):85-90. doi: 10.4274/ejbh.galenos.2021.2021-11-5.
- 11. Moiseev S, Avdeev S, Brovko M, Akulkina L, Fomin V. Cancer in intensive care unit patients with COVID-19. J Infect. 2020 Aug;81(2):e124-e125. doi: 10.1016/j.jinf.2020.05.053.
- 12. Salunke AA, Nandy K, Pathak SK, Shah J, Kamani M, Kottakota V et al. Impact of COVID -19 in cancer patients on severity of disease and fatal outcomes: A systematic review and meta-analysis. Diabetes Metab Syndr. 2020 Sep-Oct;14(5):1431-1437. doi: 10.1016/j.dsx.2020.07.037.
- 13. Liu C, Zhao Y, Okwan-Duodu D, Basho R, Cui X. COVID-19 in cancer patients: risk, clinical features, and management. Cancer Biol Med. 2020 Aug 15;17(3):519-527. doi: 10.20892/j. issn.2095-3941.2020.0289.
- 14. Liang W, Guan W, Chen R, Wang W, Li J, Xu K et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020 Mar;21(3):335-337. doi: 10.1016/ S1470-2045(20)30096-6.
- 15. Zhang L, Zhu F, Xie L, Wang C, Wang J, Chen R, et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann Oncol. 2020 Jul;31(7):894-901. doi: 10.1016/j.annonc. 2020.03.296.
- 16. Erdal GS, Polat O, Erdem GU, Korkusuz R, Hindilerden F, Yilmaz M et al. The mortality rate of COVID-19 was high in cancer patients: a retrospective single-center study. Int J Clin Oncol. 2021 May;26(5):826-834. doi: 10.1007/s10147-021-01863-6.
- 17. Qu R, Ling Y, Zhang YH, Wei LY, Chen X, Li XM et al. Platelet- to-lymphocyte ratio is associated with prognosis in patients with coronavirus disease-19. J Med Virol. 2020 Sep;92(9):1533- 1541. doi: 10.1002/jmv.25767.
- 18. Yeoh CB, Lee KJ, Rieth EF, Mapes R, Tchoudovskaia AV, Fischer GW et al. COVID-19 in the Cancer Patient. Anesth Analg. 2020 Jul;131(1):16-23. doi: 10.1213/ ANE.0000000000004884.
- 19. Dai M, Liu D, Liu M, Zhou F, Li G, Chen Z, et al. Patients with Cancer Appear More Vulnerable to SARS-CoV-2: A Multicenter Study during the COVID-19 Outbreak. Cancer Discov. 2020 Jun;10(6):783-791. doi: 10.1158/2159-8290.CD-20-0422.
- 20. Yang F, Shi S, Zhu J, Shi J, Dai K, Chen X. Clinical characteristics and outcomes of cancer patients with COVID-19. J Med Virol. 2020 Oct;92(10):2067-2073. doi: 10.1002/jmv.25972.
- 21. Lin YC, Tsai YH, Huang CC, Hsu KH, Wang SW, Tsao TC et al. Outcome of lung cancer patients with acute respiratory failure requiring mechanical ventilation. Respir Med. 2004 Jan;98(1):43-51. doi: 10.1016/j.rmed.2003.07.009.
- 22. Englum BR, Prasad NK, Lake RE, Mayorga-Carlin M, Turner DJ, Siddiqui T et al. Impact of the COVID-19 pandemic on diagnosis of new cancers: A national multicenter study of the Veterans Affairs Healthcare System. Cancer. 2022 Mar 1;128(5):1048-1056. doi: 10.1002/cncr.34011.
- 23. Kuzuu K, Misawa N, Ashikari K, Kessoku T, Kato S, Hosono K et al. Gastrointestinal Cancer Stage at Diagnosis Before and During the COVID-19 Pandemic in Japan. JAMA Netw Open. 2021 Sep 1;4(9):e2126334. doi: 10.1001/jamanetworkopen. 2021.26334.
- 24. Burki TK. Cancer care in the time of COVID-19. Lancet Oncol. 2020 May;21(5):628. doi: 10.1016/S1470-2045(20)30201-1.
- 25. Grivas P, Khaki AR, Wise-Draper TM, French B, Hennessy C, Hsu CY et al. Association of clinical factors and recent anticancer therapy with COVID-19 severity among patients with cancer: a report from the COVID-19 and Cancer Consortium. Ann Oncol. 2021 Jun;32(6):787-800. doi: 10.1016/j.annonc. 2021.02.024.
- 26. Mehta V, Goel S, Kabarriti R, Cole D, Goldfinger M, Acuna-Villaorduna A et al. Case Fatality Rate of Cancer Patients with COVID-19 in a New York Hospital System. Cancer Discov. 2020 Jul;10(7):935-941. doi: 10.1158/2159-8290.CD-20-0516.
- 27. Aboueshia M, Hussein MH, Attia AS, Swinford A, Miller P, Omar M et al. Cancer and COVID-19: analysis of patient outcomes. Future Oncol. 2021 Sep;17(26):3499-3510. doi: 10.2217/fon- 2021-0121.
- 28. Kuderer NM, Choueiri TK, Shah DP, Shyr Y, Rubinstein SM, Rivera DR et al. COVID-19 and Cancer Consortium. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study. Lancet. 2020 Jun 20;395(10241):1907-1918. doi: 10.1016/S0140-6736(20)31187-9. Epub 2020 May 28. Erratum in: Lancet. 2020 Sep 12;396(10253):758.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 23 Eylül 2023 |
| Gönderilme Tarihi | 15 Mayıs 2023 |
| Kabul Tarihi | 10 Ağustos 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 30 Sayı: 3 |
Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/Medical Journal of Süleyman Demirel University is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International.