THE IMPACT OF COVID-19 ON MORTALITY IN CANCER PATIENTS IN THE INTENSIVE CARE UNIT

Year 2023, , 396 - 403, 23.09.2023

Pınar Karabacak , Ahmet Bindal , Eyyüp Sabri Özden , Mustafa Soner Özcan , Hacı Ömer Osmanlıoğlu , Pakize Kırdemir

https://doi.org/10.17343/sdutfd.1297128

Abstract

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.

Keywords

Covid 19, Cancer, Comorbidity, Critical Care

COVİD 19’UN KANSER HASTALARINDA YOĞUN BAKIM MORTALİTESİ ÜZERİNE ETKİSİ

Abstract

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.

Keywords

Covid 19, Kanser, Komorbidite, Yoğun Bakım

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