Inflammation, but not skeletal muscle index, is associated with coronavirus disease 2019 mortality in patients with cancer.

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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.

Phase angle assessment in critically ill cancer patients: Relationship with the nutritional status, prognostic factors and death.

PURPOSE: To evaluate the relationship between phase angle (PA) and nutritional status and the prognostic significance of PA in critically ill cancer patients. METHODS: 31 patients that had been admitted to the intensive care unit (ICU) of a center on oncology were evaluated. Their PA was obtained from their bioelectrical impedance within 48 h of the ICU admission. The logistic regression analysis of Cox was used in order to identify the independent predictors of the outcomes. RESULTS: Negative and significant correlations were observed between the PA and the following variables: the length of hospital ward stay, the length of ICU stay, the total time of hospital stay, the mechanical ventilation time, and the acute physiology and chronic health evaluation II (APACHE II) scores. A positive correlation was ascertained between the PA and albumin. PA was significantly associated with death. Patients with a PA ≤3.8° presented a significantly shorter survival time than those with a PA >3.8°. CONCLUSION: PA was a prognostic marker in this population, independently of previously established prognostic factors. PA can represent a clinically feasible approach for the initial identification of critically ill cancer patients who require an early and specialized nutritional intervention.