Nutrition and Dietetics Section, Cancer Hospital I, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil.
Nutrition and Dietetics Section, Cancer Hospital I, Brazilian National Cancer Institute (INCA), Rio de Janeiro, Brazil.
Clin Nutr ESPEN. 2024 Aug;62:185-191. doi: 10.1016/j.clnesp.2024.05.024. Epub 2024 May 29.
BACKGROUND & AIMS: Patients with cancer and coronavirus disease 2019 (COVID-19) have characteristics that can cause the most severe forms of the disease and higher mortality. We aimed to assess the association between computed tomography (CT)-derived muscle abnormalities, anthropometric parameters, inflammation, and mortality in patients with cancer and COVID-19.
This retrospective study included patients with cancer and COVID-19 admitted between March 1st and December 31st, 2020. All information was collected from medical records (clinical and nutritional parameters, serum albumin, and C-reactive protein [CRP]). Weight loss and body mass index (BMI) were assessed using Global Leadership Initiative on Malnutrition phenotypic criteria. Skeletal muscle index (SMI) and skeletal muscle radiodensity (SMD) at the fourth thoracic vertebra level were assessed using computed tomography scans.
This study included 80 patients (61% men, mean age: 58 ± 17 years). Of the patients analyzed, 49% had weight loss >5%, and 14% had low BMI. The median length of hospital stay was 7 (interquartile range: 4-14 days), 27% needed mechanical ventilation, 34% died as a direct consequence of COVID-19 infection and 15% to complications associated with cancer condition. In multivariate logistic regression analysis, low SMI was associated with increased in-hospital mortality [odds ratio (OR): 4.81; 95% confidence interval (95% CI): 1.63; 14.2; p = 0.005), while CRP was associated with COVID-19-related mortality (OR: 1.08; 95% CI: 1.01; 1.15, p = 0.018).
SMI independently predicts in-hospital mortality in patients with cancer and COVID-19. Additionally, an independent association was observed between CRP and mortality specifically related to COVID-19.
患有癌症和 2019 冠状病毒病（COVID-19）的患者具有导致疾病最严重形式和更高死亡率的特征。我们旨在评估癌症和 COVID-19 患者的计算机断层扫描（CT）衍生肌肉异常、人体测量参数、炎症和死亡率之间的关系。
本回顾性研究纳入了 2020 年 3 月 1 日至 12 月 31 日期间收治的癌症合并 COVID-19 的患者。所有信息均从病历中收集（临床和营养参数、血清白蛋白和 C 反应蛋白[CRP]）。使用全球营养不良领导倡议表型标准评估体重减轻和体重指数（BMI）。使用 CT 扫描评估第四胸椎水平的骨骼肌指数（SMI）和骨骼肌放射密度（SMD）。
本研究纳入了 80 例患者（61%为男性，平均年龄：58±17 岁）。分析的患者中，49%有体重减轻>5%，14%有低 BMI。中位住院时间为 7 天（四分位间距：4-14 天），27%需要机械通气，34%因 COVID-19 感染直接死亡，15%因癌症相关并发症死亡。多变量逻辑回归分析显示，低 SMI 与住院期间死亡率增加相关[比值比（OR）：4.81；95%置信区间（95%CI）：1.63；14.2；p=0.005），而 CRP 与 COVID-19 相关死亡率相关（OR：1.08；95%CI：1.01；1.15，p=0.018）。
SMI 可独立预测癌症和 COVID-19 患者的住院死亡率。此外，还观察到 CRP 与 COVID-19 相关死亡率之间存在独立关联。
