tetano
Editor, Senior Moderator
Eur J Haematol
. 2020 Jul 24.
doi: 10.1111/ejh.13493. Online ahead of print.
Clinical course and risk factors for mortality from COVID-19 in patients with haematological malignancies
Jos? Mar?a Sanchez-Pina[SUP] 1 [/SUP], Mario Rodr?guez Rodriguez[SUP] 1 [/SUP], Nerea Castro Quismondo[SUP] 1 [/SUP], Rodrigo Gil Manso[SUP] 1 [/SUP], Rafael Colmenares[SUP] 1 [/SUP], Daniel Gil Alos[SUP] 1 [/SUP], Mari Liz Paciello[SUP] 1 [/SUP], Denis Zafra[SUP] 1 [/SUP], Cristina Garcia-Sanchez[SUP] 1 [/SUP], Carolina Villegas[SUP] 1 [/SUP], Clara Cuellar[SUP] 1 [/SUP], Gonzalo Carre?o[SUP] 1 [/SUP], Irene Zamanillo[SUP] 1 [/SUP], Mar?a Poza[SUP] 1 [/SUP], Rodrigo I?iguez[SUP] 1 [/SUP], Xabier Gutierrez[SUP] 1 [/SUP], Rafael Alonso[SUP] 1 [/SUP], Antonia Rodr?guez[SUP] 1 [/SUP], Maria Dolores Folgueira[SUP] 2 [/SUP], Rafael Delgado[SUP] 2 [/SUP], Jos? Miguel Ferrari[SUP] 3 [/SUP], Manuel Lizasoain[SUP] 4 [/SUP], Jos? Mar?a Aguado[SUP] 4 [/SUP], Rosa Ayala[SUP] 1 [/SUP], Joaqu?n Martinez-Lopez[SUP] 1 [/SUP], Mar?a Calbacho[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The impact of coronavirus disease 2019 (COVID-19) in haematological patients (HP) has not been reported to date.
Methods: We analyzed 39 patients with SARS-CoV-2 infection and haematological malignancies. Clinical characteristics and outcomes were compared to a matched control group of 53 non-cancer patients with COVID-19. Univariate and multivariate analyses were carried out to assess the risk factors associated with poor outcome.
Results: The most frequent haematological diseases were lymphoma (30%) and multiple myeloma (30%). Eighty-seven % HP developed moderate or severe disease. Patients with haematological malignancies had a significantly higher mortality rate compared to non-cancer patients (35.9% vs 13.2%; P=0.003 (odds ratio 6.652). The worst outcome was observed in chronic lymphocytic leukemia patients. Only age >70 years and C reactive protein >10 mg/dl at admission were associated with higher risk of death (odds ratio 34.86, p= 0.003 and 13.56, p=0.03). Persistant viral sheddind was detected in 5 HP. Active chemotherapy, viral load at diagnosis and COVID-19 therapy were not predictors of outcome.
Conclusion: Mortality of COVID-19 is significantly higher in patients with haematological malignancies compared to non-cancer patients. The impact of persistant viral shedding must be considered in order to re-start therapies and maintain infectious control measures.
Keywords: COVID-19; SARS-CoV-2; cancer; haematology; outcome.
. 2020 Jul 24.
doi: 10.1111/ejh.13493. Online ahead of print.
Clinical course and risk factors for mortality from COVID-19 in patients with haematological malignancies
Jos? Mar?a Sanchez-Pina[SUP] 1 [/SUP], Mario Rodr?guez Rodriguez[SUP] 1 [/SUP], Nerea Castro Quismondo[SUP] 1 [/SUP], Rodrigo Gil Manso[SUP] 1 [/SUP], Rafael Colmenares[SUP] 1 [/SUP], Daniel Gil Alos[SUP] 1 [/SUP], Mari Liz Paciello[SUP] 1 [/SUP], Denis Zafra[SUP] 1 [/SUP], Cristina Garcia-Sanchez[SUP] 1 [/SUP], Carolina Villegas[SUP] 1 [/SUP], Clara Cuellar[SUP] 1 [/SUP], Gonzalo Carre?o[SUP] 1 [/SUP], Irene Zamanillo[SUP] 1 [/SUP], Mar?a Poza[SUP] 1 [/SUP], Rodrigo I?iguez[SUP] 1 [/SUP], Xabier Gutierrez[SUP] 1 [/SUP], Rafael Alonso[SUP] 1 [/SUP], Antonia Rodr?guez[SUP] 1 [/SUP], Maria Dolores Folgueira[SUP] 2 [/SUP], Rafael Delgado[SUP] 2 [/SUP], Jos? Miguel Ferrari[SUP] 3 [/SUP], Manuel Lizasoain[SUP] 4 [/SUP], Jos? Mar?a Aguado[SUP] 4 [/SUP], Rosa Ayala[SUP] 1 [/SUP], Joaqu?n Martinez-Lopez[SUP] 1 [/SUP], Mar?a Calbacho[SUP] 1 [/SUP]
Affiliations
- PMID: 32710500
- DOI: 10.1111/ejh.13493
Abstract
Background: The impact of coronavirus disease 2019 (COVID-19) in haematological patients (HP) has not been reported to date.
Methods: We analyzed 39 patients with SARS-CoV-2 infection and haematological malignancies. Clinical characteristics and outcomes were compared to a matched control group of 53 non-cancer patients with COVID-19. Univariate and multivariate analyses were carried out to assess the risk factors associated with poor outcome.
Results: The most frequent haematological diseases were lymphoma (30%) and multiple myeloma (30%). Eighty-seven % HP developed moderate or severe disease. Patients with haematological malignancies had a significantly higher mortality rate compared to non-cancer patients (35.9% vs 13.2%; P=0.003 (odds ratio 6.652). The worst outcome was observed in chronic lymphocytic leukemia patients. Only age >70 years and C reactive protein >10 mg/dl at admission were associated with higher risk of death (odds ratio 34.86, p= 0.003 and 13.56, p=0.03). Persistant viral sheddind was detected in 5 HP. Active chemotherapy, viral load at diagnosis and COVID-19 therapy were not predictors of outcome.
Conclusion: Mortality of COVID-19 is significantly higher in patients with haematological malignancies compared to non-cancer patients. The impact of persistant viral shedding must be considered in order to re-start therapies and maintain infectious control measures.
Keywords: COVID-19; SARS-CoV-2; cancer; haematology; outcome.