Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
PLoS One. 2023 Aug 29;18(8):e0287649. doi: 10.1371/journal.pone.0287649. eCollection 2023.
Adult cancer patients with COVID-19 were shown to be at higher risk of Intensive Care Unit (ICU) admission. Previously published prediction models showed controversy and enforced the importance of heterogeneity among different populations studied. Therefore, this study aimed to identify predictors of ICU admission (demographic, clinical, and COVID-19 targeted medications) in cancer patients with active COVID-19 infection presenting to the Emergency Department (ED).
This is a retrospective cohort study. It was conducted on adult cancer patients older than 18 years who presented to the American University of Beirut Medical Center ED from February 21, 2020, till February 21, 2021, and were found to have COVID-19 infection. Relevant data were extracted from electronic medical records. The association between different variables and ICU admission was tested. Logistic regression was done to adjust for confounding variables. A p-value less than 0.05 was considered significant.
Eighty-nine distinct patients were included. About 37% were admitted to the ICU (n = 33). Higher ICU admission was seen in patients who had received chemotherapy within one month, had a respiratory rate at triage above 22 breaths per minute, oxygen saturation less than 95%, and a higher c-reactive protein upon presentation to the ED. After adjusting for confounding variables, only recent chemotherapy and higher respiratory rate at triage were significantly associated with ICU admission.
Physicians need to be vigilant when taking care of COVID-19 infected cancer patients. Patients who are tachypneic at presentation and those who have had chemotherapy within one month are at high risk for ICU admission.
患有 COVID-19 的成年癌症患者被认为有更高的入住重症监护病房（ICU）的风险。先前发表的预测模型存在争议，这强调了不同研究人群之间异质性的重要性。因此，本研究旨在确定在因 COVID-19 感染而到急诊就诊的癌症患者中，预测 ICU 入住（人口统计学、临床和针对 COVID-19 的药物）的因素（包括癌症患者的人口统计学、临床和 COVID-19 靶向药物）。
这是一项回顾性队列研究。研究对象为 2020 年 2 月 21 日至 2021 年 2 月 21 日期间，因 COVID-19 感染而到贝鲁特美国大学医学中心急诊就诊的年龄大于 18 岁的成年癌症患者。从电子病历中提取相关数据。检验了不同变量与 ICU 入住之间的关联。使用逻辑回归来调整混杂变量。p 值小于 0.05 被认为具有统计学意义。
共纳入 89 名不同的患者。约 37%（n = 33）的患者被收入 ICU。在接受化疗治疗一个月内、分诊时呼吸频率大于 22 次/分钟、氧饱和度小于 95%和就诊时 C 反应蛋白较高的患者中，ICU 入住率较高。调整混杂变量后，只有近期化疗和分诊时较高的呼吸频率与 ICU 入住显著相关。
医生在照顾 COVID-19 感染的癌症患者时需要保持警惕。就诊时出现呼吸急促和一个月内接受过化疗的患者有较高的 ICU 入住风险。
