Timing and Causes of Death in Severe COVID-19 Patients

Roquetaillade, Charles de; Bredin, Swann; Lascarrou, Jean-Baptiste; Soumagne, Thibaud; Cojocaru, Mariana; Chousterman, Benjamin; Leclerc, Maxime; Gouhier, Albin; Piton, Gaël; Pène, Frédéric; Stoclin, Annabelle; Llitjos, Jean-François

doi:10.21203/rs.3.rs-179159/v1

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…However, these nosocomial complications were considered responsible for only a low proportion of deaths, as assessed by physicians. These results must be interpreted cautiously, given controversial data regarding both the relatively low attributable mortality of nosocomial infections in septic patients and the variability in the definition of causes of death ( 21 ). Third, an increased risk of thromboembolic events could explain higher mortality rates among cancer patients.…”

Section: Discussionmentioning

confidence: 98%

Outcomes of Patients With Active Cancer and COVID-19 in the Intensive-Care Unit: A Multicenter Ambispective Study

Plais

Labreuche²,

Creutin

et al. 2022

Front. Oncol.

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BackgroundSeveral studies report an increased susceptibility to SARS-CoV-2 infection in cancer patients. However, data in the intensive care unit (ICU) are scarce.Research QuestionWe aimed to investigate the association between active cancer and mortality among patients requiring organ support in the ICU.Study Design and MethodsIn this ambispective study encompassing 17 hospitals in France, we included all adult active cancer patients with SARS-CoV-2 infection requiring organ support and admitted in ICU. For each cancer patient, we included 3 non cancer patients as controls. Patients were matched at the same ratio using the inverse probability weighting approach based on a propensity score assessing the probability of cancer at admission. Mortality at day 60 after ICU admission was compared between cancer patients and non-cancer patients using primary logistic regression analysis and secondary multivariable analyses.ResultsBetween March 12, 2020 and March 8, 2021, 2608 patients were admitted with SARS-CoV-2 infection in our study, accounting for 2.8% of the total population of patients with SARS-CoV-2 admitted in all French ICUs within the same period. Among them, 105 (n=4%) presented with cancer (51 patients had hematological malignancy and 54 patients had solid tumors). 409 of 420 patients were included in the propensity score matching process, of whom 307 patients in the non-cancer group and 102 patients in the cancer group. 145 patients (35%) died in the ICU at day 60, 59 (56%) with cancer and 86 (27%) without cancer. In the primary logistic regression analysis, the odds ratio for death associated to cancer was 2.3 (95%CI 1.24 – 4.28, p=0.0082) higher for cancer patients than for a non-cancer patient at ICU admission. Exploratory multivariable analyses showed that solid tumor (OR: 2.344 (0.87-6.31), p=0.062) and hematological malignancies (OR: 4.144 (1.24-13.83), p=0.062) were independently associated with mortality.InterpretationPatients with cancer and requiring ICU admission for SARS-CoV-2 infection had an increased mortality, hematological malignancy harboring the higher risk in comparison to solid tumors.

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Section: Discussionmentioning

confidence: 98%

Outcomes of Patients With Active Cancer and COVID-19 in the Intensive-Care Unit: A Multicenter Ambispective Study

Plais

Labreuche²,

Creutin

et al. 2022

Front. Oncol.

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Global prevalence and effect of comorbidities and smoking status on severity and mortality of COVID-19 in association with age and gender: a systematic review, meta-analysis and meta-regression

Chenchula

Vidyasagar²,

Pathan

et al. 2023

Sci Rep

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A COVID-19 patient often presents with multiple comorbidities and is associated with adverse outcomes. A comprehensive assessment of the prevalence of comorbidities in patients with COVID-19 is essential. This study aimed to assess the prevalence of comorbidities, severity and mortality with regard to geographic region, age, gender and smoking status in patients with COVID-19. A systematic review and multistage meta-analyses were reported using PRISMA guidelines. PubMed/MEDLINE, SCOPUS, Google Scholar and EMBASE were searched from January 2020 to October 2022. Cross-sectional studies, cohort studies, case series studies, and case–control studies on comorbidities reporting among the COVID-19 populations that were published in English were included. The pooled prevalence of various medical conditions in COVID-19 patients was calculated based on regional population size weights. Stratified analyses were performed to understand the variations in the medical conditions based on age, gender, and geographic region. A total of 190 studies comprising 105 million COVID-19 patients were included. Statistical analyses were performed using STATA software, version 16 MP (StataCorp, College Station, TX). Meta-analysis of proportion was performed to obtain pooled values of the prevalence of medical comorbidities: hypertension (39%, 95% CI 36–42, n = 170 studies), obesity (27%, 95% CI 25–30%, n = 169 studies), diabetes (27%, 95% CI 25–30%, n = 175), and asthma (8%, 95% CI 7–9%, n = 112). Moreover, the prevalence of hospitalization was 35% (95% CI 29–41%, n = 61), intensive care admissions 17% (95% CI 14–21, n = 106), and mortality 18% (95% CI 16–21%, n = 145). The prevalence of hypertension was highest in Europe at 44% (95% CI 39–47%, n = 68), obesity and diabetes at 30% (95% CI, 26–34, n = 79) and 27% (95%CI, 24–30, n = 80) in North America, and asthma in Europe at 9% (95% CI 8–11, n = 41). Obesity was high among the ≥ 50 years (30%, n = 112) age group, diabetes among Men (26%, n = 124) and observational studies reported higher mortality than case–control studies (19% vs. 14%). Random effects meta-regression found a significant association between age and diabetes (p < 0.001), hypertension (p < 0.001), asthma (p < 0.05), ICU admission (p < 0.05) and mortality (p < 0.001). Overall, a higher global prevalence of hypertension (39%) and a lower prevalence of asthma (8%), and 18% of mortality were found in patients with COVID-19. Hence, geographical regions with respective chronic medical comorbidities should accelerate regular booster dose vaccination, preferably to those patients with chronic comorbidities, to prevent and lower the severity and mortality of COVID-19 disease with novel SARS-CoV-2 variants of concern (VOC).

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Timing and Causes of Death in Severe COVID-19 Patients

Cited by 2 publications

References 18 publications

Outcomes of Patients With Active Cancer and COVID-19 in the Intensive-Care Unit: A Multicenter Ambispective Study

Outcomes of Patients With Active Cancer and COVID-19 in the Intensive-Care Unit: A Multicenter Ambispective Study

Global prevalence and effect of comorbidities and smoking status on severity and mortality of COVID-19 in association with age and gender: a systematic review, meta-analysis and meta-regression

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