INTRODUCTION
Today, oncological diseases are widespread throughout the world, which causes increased attention from doctors to this category of patients. According to numerous studies, the infection rate of cancer and non-cancer patients with COVID-19 infection is comparable, but there is evidence that people with malignant diseases have an increased risk of mortality from complications caused by the SARS-CoV-2 virus.
OBJECTIVE
To study the the features of the course of COVID-19 infection in patients with malignant oncological diseases in the intensive care unit.
MATERIAL AND METHODS
The study included clinical and laboratory data from 54 cancer patients aged 18 to 95 years (mean age 66.4±2.7 years) who were infected with COVID-19 and were in the intensive care unit. Patients received one of the treatment options for coronavirus infection with monoclonal antibodies or an antiviral drug in combination with a monoclonal antibody. Respiratory support included non-invasive ventilation (NIV) and mechanical ventilation (adaptive lung ventilation — ALV). The results of instrumental studies and laboratory data before and after the start of treatment were compared, and the degree of mortality was assessed. At the time of the study, patients with malignant neoplasms did not receive therapy for the underlying disease due to the severity of their condition and their stay in the intensive care unit.
RESULTS
According to the results obtained, the presence of cancer did not have a statistically significant effect on the duration of hospitalization for novel coronavirus infection (p=0.55). As a result of the treatment of COVID-19, it was possible to achieve a significant decrease only in the level of C-reactive protein from 65.5±16.9 g/l to 40.9±20.0 g/l (p=0.007), while in 22 people (61.1%), an elevated level of this inflammatory marker remained. The presence of oncological pathology was not associated with the level of CRP (Fisher’s test p=0.88), leukocytes (Fisher’s test p=0.26), and lymphocytes (Fisher’s test p=0.18) before treatment. In cancer patients, IL-6 and TNF-α levels remained above the normal range throughout the course of the disease and reached a second peak in the fourth or fifth week. It was found that deceased cancer patients had significantly more severe immune dysregulation compared to discharged patients, including IL-2, IL-6, IL-8, IL-10 and TNF-α. Mortality among cancer patients due to COVID-19 infection was 1.9% (n=1).
CONCLUSION
Patients with malignant neoplasms are at high risk of developing a severe course of COVID-19 infection, due to the characteristics of the immune status, as well as the severity of the underlying disease.
