“Predictors of in-hospital mortality in adult cancer patients with COVID-19 infection presenting to the emergency department: A retrospective study”

Abstract

Background 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. Methods 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. Results 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). Conclusions 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.

Rapid dynamic changes of FL.2 variant: A case report of COVID-19 breakthrough infection

“…The US Centers for Disease Control observed a 10% increase in the rate of hospitalization since Dec of 2022 when FL.2 was circulating, however at the time of this report, FL.2 was being replaced with Omicron variants EG.5.1 in the USA and BA.2.6 in the rest of the world ( https://covid.cdc.gov/covid-data-tracker ). Older patients with underlying chronic comorbidities constitute high-risk populations prone to persistent SARS-CoV-2 infections, higher rates of intensive care unit admission, invasive mechanical ventilation, and death [3 , 12 , 13] .…”

“…Typically, the virus is cleared within 2 weeks of infection, but immunocompromised individuals can have prolonged infections [1 , 2] . Weak immune systems increase infection risk and post-COVID-19 clinical sequelae, even post-vaccination [3] . Prolonged infections may facilitate viral evolution, including the evolution of immune-evasive viral variants.…”