COVİD 19’UN KANSER HASTALARINDA YOĞUN BAKIM MORTALİTESİ ÜZERİNE ETKİSİ

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

• Covid 19
• Kanser
• Komorbidite
• Yoğun Bakım

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

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

• Covid 19
• Cancer
• Comorbidity
• Critical Care

Kaynakça

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