Clinical Evolution and Prognostic Factors of Cancer Patients with COVID-19 on Mechanical Ventilation

• Autor(a) principal: Santos, Michelle Queres dos
• Data de Publicação: 2024
• Outros Autores: Cavalcante, Everton Araújo, Almeida, Isabel Cid Taboada, Gutierrez, Ana Cristina Machado Leão, Fireman, Kelly, Quintão, Monica Pena, Bergmann, Anke, Barufaldi, Laura Augusta
• Tipo de documento: Artigo
• Idioma: por; eng; spa
• Título da fonte: Revista Brasileira de Cancerologia (Online)
• Texto Completo: https://rbc.inca.gov.br/index.php/revista/article/view/4468
• topic: Neoplasias/epidemiologia; COVID-19; Síndrome do Desconforto Respiratório; Cuidados Críticos; Ventiladores Mecânicos; Neoplasms/epidemiology; COVID-19; Respiratory Distress Syndrome; Critical Care; Ventilators, Mechanical; Neoplasias/epidemiología; COVID-19; Síndrome de Dificultad Respiratoria; Cuidados Críticos; Ventiladores Mecánicos

Introduction: Cancer patients were at risk of developing severe respiratory conditions when affected by COVID-19, requiring intensive support and invasive mechanical ventilation (IMV). Objective: Evaluate the factors associated with death of cancer patients by COVID-19 who developed respiratory failure and need of IMV. Method: Retrospective cohort study of cancer patients in an oncology intensive care unit (ICU), with COVID-19 and on IMV was carried out from April 2020 to December 2021. All patients with cancer admitted to the ICU on IMV or who developed IMV due to worsening of COVID-19 were sequentially included, excluding those who had been in follow-up of the oncological disease for more than five years. For statistical analysis, measures of central tendency and dispersion were used, as well as absolute and relative frequencies. Multiple logistic regression was applied to evaluate factors associated with mortality, considering statistically significant values of p < 0.05. Results: 85 patients were included in the study. Death was higher for patients with solid tumors (OR = 3.64; 95% CI, 1.06-12.52; p = 0.04), in addition to those who required renal support while in ICU (OR = 6.88; 95% CI, 1.82-25.98; p = 0.004), those who could not be extubated (OR = 8.00; 95% CI, 2.16-29.67; p = 0.002) and who presented an alveolar distension pressure value greater than 15cmH2O for at least one day (OR = 5.9; 95% CI, 1.76-19.80; p = 0.004). Conclusion: Clinical and IMV characteristics were associated with death in cancer patients with COVID-19 and IMV.