Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
PLoS One. 2023 Jan 26;18(1):e0278898. doi: 10.1371/journal.pone.0278898. eCollection 2023.
Adult cancer patients are at higher risk of morbidity and mortality following COVID-19 infection. Being on the front lines, it is crucial for emergency physicians to identify those who are at higher risk of mortality. The aim of our study was to determine the predictors of in-hospital mortality in COVID-19 positive cancer patients who present to the emergency department.
This is a retrospective cohort study conducted on adult cancer patients who presented to the ED of the American university of Beirut medical center from February 21, 2020, till February 21, 2021, and were found to have COVID-19 infection. Relevant data was extracted and analyzed. The association between different variables and in-hospital mortality was tested using Student's t test and Fisher's exact test or Pearson's Chi-square where appropriate. Logistic regression was applied to factors with p <0.2 in the univariate models.
The study included 89 distinct patients with an average age of 66 years (± 13.6). More than half of them were smokers (52.8%) and had received chemotherapy within 1 month of presentation (52.8%). About one third of the patients died (n = 31, 34.8%). Mortality was significantly higher in patients who had recently received chemotherapy (67.7% vs 44.8%, p = .039), a history of congestive heart failure (CHF)(p = .04), higher levels of CRP (p = 0.048) and/or PCT(p<0.04) or were tachypneic in the ED (P = 0.016).
Adult cancer patients with COVID-19 infection are at higher risks of mortality if they presented with tachypnea, had a recent chemotherapy, history of CHF, high CRP, and high procalcitonin levels at presentation.
成年癌症患者在感染 COVID-19 后患病和死亡的风险更高。作为抗疫一线人员，急诊医生必须识别出那些死亡风险更高的患者。我们的研究目的是确定因 COVID-19 感染而就诊于急诊的成年癌症患者的院内死亡预测因子。
这是一项回顾性队列研究，纳入了 2020 年 2 月 21 日至 2021 年 2 月 21 日期间因 COVID-19 感染就诊于贝鲁特美国大学医学中心急诊部的成年癌症患者。提取并分析了相关数据。使用 Student's t 检验、Fisher 确切检验或 Pearson 卡方检验（适当情况下）来检验不同变量与院内死亡率之间的关联。对单变量模型中 p<0.2 的因素应用逻辑回归。
本研究纳入了 89 例不同的患者，平均年龄为 66 岁（±13.6）。超过一半的患者为吸烟者（52.8%），且在就诊前 1 个月内接受过化疗（52.8%）。约三分之一的患者死亡（n=31，34.8%）。近期接受化疗（67.7% vs 44.8%，p=0.039）、充血性心力衰竭（CHF）病史（p=0.04）、CRP 水平较高（p=0.048）和/或 PCT（p<0.04）或就诊时呼吸急促的患者死亡率显著更高（p=0.016）。
因 COVID-19 感染就诊的成年癌症患者如果就诊时呼吸急促、近期接受化疗、有 CHF 病史、CRP 和降钙素原水平较高，则死亡风险更高。
