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0 0.5 1 1.5 2+ Mortality -25% Improvement Relative Risk Remdesivir for COVID-19  Liao et al.  LATE TREATMENT Is late treatment with remdesivir beneficial for COVID-19? Retrospective 65 patients in Taiwan (May - September 2022) No significant difference in mortality Liao et al., BMC Pulmonary Medicine, Jan 2024 Favors remdesivir Favors control

Clinical characteristics and outcomes among critically ill patients with cancer and COVID-19-related acute respiratory failure

Liao et al., BMC Pulmonary Medicine, doi:10.1186/s12890-024-02850-z
Jan 2024  
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Retrospective study of 215 critically ill COVID-19 patients with respiratory failure showing higher mortality for cancer patients. Remdesivir was used more for non-survivors, without statistical significance. Most patients received remdesivir, suggesting standard use for critically ill patients at the time, however it is not clear why some patients did not receive treatment, and baseline details per group are not provided.
Gérard, Wu, Zhou show significantly increased risk of acute kidney injury with remdesivir.
This study is excluded in the after exclusion results of meta analysis: unadjusted results with no group details.
risk of death, 25.4% higher, RR 1.25, p = 0.67, treatment 37 of 59 (62.7%), control 3 of 6 (50.0%), day 120.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Liao et al., 15 Jan 2024, retrospective, Taiwan, peer-reviewed, median age 73.0, 10 authors, study period May 2022 - September 2022. Contact:
This PaperRemdesivirAll
Clinical characteristics and outcomes among critically ill patients with cancer and COVID-19-related acute respiratory failure
Ying-Ting Liao, Hsiao-Chin Shen, Jhong-Ru Huang, Chuan-Yen Sun, Hung-Jui Ko, Chih-Jung Chang, Yuh-Min Chen, Jia-Yih Feng, Wei-Chih Chen, Kuang-Yao Yang
BMC Pulmonary Medicine, doi:10.1186/s12890-024-02850-z
Background Coronavirus disease 2019 (COVID-19) has affected individuals worldwide, and patients with cancer are particularly vulnerable to COVID-19-related severe illness, respiratory failure, and mortality. The relationship between COVID-19 and cancer remains a critical concern, and a comprehensive investigation of the factors affecting survival among patients with cancer who develop COVID-19-related respiratory failure is warranted. We aim to compare the characteristics and outcomes of COVID-19-related acute respiratory failure in patients with and without underlying cancer, while analyzing factors affecting in-hospital survival among cancer patients. Methods We conducted a retrospective observational study at Taipei Veterans General Hospital in Taiwan from May to September 2022, a period during which the omicron variant of the severe acute respiratory syndrome coronavirus 2 was circulating. Eligible patients had COVID-19 and acute respiratory failure. Clinical data, demographic information, disease severity markers, treatment details, and outcomes were collected and analyzed. Results Of the 215 enrolled critically ill patients with COVID-19, 65 had cancer. The patients with cancer were younger and had lower absolute lymphocyte counts, higher ferritin and lactate dehydrogenase (LDH) concentrations, and increased vasopressor use compared with those without cancer. The patients with cancer also received more COVID-19 specific treatments but had higher in-hospital mortality rate (61.5% vs 36%, P = 0.002) and longer viral shedding (13 vs 10 days, P = 0.007) than those without cancer did. Smoking [odds ratio (OR): 5.804, 95% confidence interval (CI): 1.847-39.746], elevated LDH (OR: 1.004, 95% CI: 1.001-1.012), vasopressor use (OR: 5.437, 95% CI: 1.202-24.593), and new renal replacement therapy (OR: 3.523, 95% CI: 1.203-61.108) were independent predictors of in-hospital mortality among patients with cancer and respiratory failure. Conclusion Critically ill patients with cancer experiencing COVID-19-related acute respiratory failure present unique clinical features and worse clinical outcomes compared with those without cancer. Smoking, elevated LDH, vasopressor use, and new renal replacement therapy were risk factors for in-hospital mortality in these patients.
Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1186/ s12890-024-02850-z. Additional file 1. Authors' contributions Conceptualization: Ying-Ting Liao, Hsiao-Chin Shen, Jhong-Ru Huang, Chuan-Yen Sun, Hung-Jui Ko, Chih-Jung Chang, Jia-Yih Feng, Wei-Chih Chen, Kuang-Yao Yang. Supervision: Wei-Chih Chen, Jia-Yih Feng, Kuang-Yao Yang, Yuh-Min Chen. Data Collection and/or Processing: Hsiao-Chin Shen, Chuan-Yen Sun, Jhong-Ru Huang, Ying-Ting Liao, Hung-Jui Ko, Chih-Jung Chang. Analysis and/ or Interpretation: Ying-Ting Liao, Wei-Chih Chen, Kuang-Yao Yang. Writingoriginal draft: Ying-Ting Liao, Wei-Chih Chen, Kuang-Yao Yang. Writing -review and editing: Ying-Ting Liao, Wei-Chih Chen, Kuang-Yao Yang. All authors read and approved the final manuscript. Declarations Ethics approval and consent to participate This retrospective study was performed in accordance with the Declaration of Helsinki and approved by the Institutional Ethical Review Board of Taipei Veterans General Hospital (Approval No. 2022-11-002 AC). Written informed consent was waived by Institutional Ethical Review Board of Taipei Veterans General Hospital due to retrospective design of the study. Consent for publication Not applicable. Competing interests The authors declare no competing interests. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Late treatment
is less effective
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