TY - JOUR
T1 - COVID-19 infection in adult patients with hematological malignancies
T2 - a European Hematology Association Survey (EPICOVIDEHA)
AU - EPICOVIDEHA working group
AU - Pagano, Livio
AU - Salmanton-García, Jon
AU - Marchesi, Francesco
AU - Busca, Alessandro
AU - Corradini, Paolo
AU - Hoenigl, Martin
AU - Klimko, Nikolai
AU - Koehler, Philipp
AU - Pagliuca, Antonio
AU - Passamonti, Francesco
AU - Verga, Luisa
AU - Víšek, Benjamin
AU - Ilhan, Osman
AU - Nadali, Gianpaolo
AU - Weinbergerová, Barbora
AU - Córdoba-Mascuñano, Raúl
AU - Marchetti, Monia
AU - Collins, Graham P.
AU - Farina, Francesca
AU - Cattaneo, Chiara
AU - Cabirta, Alba
AU - Gomes-Silva, Maria
AU - Itri, Federico
AU - van Doesum, Jaap
AU - Ledoux, Marie Pierre
AU - Čerňan, Martin
AU - Jakšić, Ozren
AU - Duarte, Rafael F.
AU - Magliano, Gabriele
AU - Omrani, Ali S.
AU - Fracchiolla, Nicola S.
AU - Kulasekararaj, Austin
AU - Valković, Toni
AU - Poulsen, Christian Bjørn
AU - Machado, Marina
AU - Glenthøj, Andreas
AU - Stoma, Igor
AU - Ráčil, Zdeněk
AU - Piukovics, Klára
AU - Navrátil, Milan
AU - Emarah, Ziad
AU - Sili, Uluhan
AU - Maertens, Johan
AU - Blennow, Ola
AU - Bergantim, Rui
AU - García-Vidal, Carolina
AU - Prezioso, Lucia
AU - Guidetti, Anna
AU - del Principe, Maria Ilaria
AU - Ali, Natasha
N1 - Publisher Copyright:
© 2021, The Author(s).
PY - 2021/12
Y1 - 2021/12
N2 - Background: Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality. Methods: The survey was supported by the Scientific Working Group Infection in Hematology of the European Hematology Association (EHA). Eligible for the analysis were adult patients with HM and laboratory-confirmed COVID-19 observed between March and December 2020. Results: The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma n = 1084, myeloma n = 684 and chronic lymphoid leukemia n = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia n = 497 and myelodysplastic syndromes n = 279). Severe/critical COVID-19 was observed in 63.8% of patients (n = 2425). Overall, 2778 (73.1%) of the patients were hospitalized, 689 (18.1%) of whom were admitted to intensive care units (ICUs). Overall, 1185 patients (31.2%) died. The primary cause of death was COVID-19 in 688 patients (58.1%), HM in 173 patients (14.6%), and a combination of both COVID-19 and progressing HM in 155 patients (13.1%). Highest mortality was observed in acute myeloid leukemia (199/497, 40%) and myelodysplastic syndromes (118/279, 42.3%). The mortality rate significantly decreased between the first COVID-19 wave (March–May 2020) and the second wave (October–December 2020) (581/1427, 40.7% vs. 439/1773, 24.8%, p value < 0.0001). In the multivariable analysis, age, active malignancy, chronic cardiac disease, liver disease, renal impairment, smoking history, and ICU stay correlated with mortality. Acute myeloid leukemia was a higher mortality risk than lymphoproliferative diseases. Conclusions: This survey confirms that COVID-19 patients with HM are at high risk of lethal complications. However, improved COVID-19 prevention has reduced mortality despite an increase in the number of reported cases.
AB - Background: Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality. Methods: The survey was supported by the Scientific Working Group Infection in Hematology of the European Hematology Association (EHA). Eligible for the analysis were adult patients with HM and laboratory-confirmed COVID-19 observed between March and December 2020. Results: The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma n = 1084, myeloma n = 684 and chronic lymphoid leukemia n = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia n = 497 and myelodysplastic syndromes n = 279). Severe/critical COVID-19 was observed in 63.8% of patients (n = 2425). Overall, 2778 (73.1%) of the patients were hospitalized, 689 (18.1%) of whom were admitted to intensive care units (ICUs). Overall, 1185 patients (31.2%) died. The primary cause of death was COVID-19 in 688 patients (58.1%), HM in 173 patients (14.6%), and a combination of both COVID-19 and progressing HM in 155 patients (13.1%). Highest mortality was observed in acute myeloid leukemia (199/497, 40%) and myelodysplastic syndromes (118/279, 42.3%). The mortality rate significantly decreased between the first COVID-19 wave (March–May 2020) and the second wave (October–December 2020) (581/1427, 40.7% vs. 439/1773, 24.8%, p value < 0.0001). In the multivariable analysis, age, active malignancy, chronic cardiac disease, liver disease, renal impairment, smoking history, and ICU stay correlated with mortality. Acute myeloid leukemia was a higher mortality risk than lymphoproliferative diseases. Conclusions: This survey confirms that COVID-19 patients with HM are at high risk of lethal complications. However, improved COVID-19 prevention has reduced mortality despite an increase in the number of reported cases.
KW - COVID-19
KW - EHA
KW - Epidemiology
KW - Hematological malignancies
KW - Pandemic
UR - http://www.scopus.com/inward/record.url?scp=85117512005&partnerID=8YFLogxK
U2 - 10.1186/s13045-021-01177-0
DO - 10.1186/s13045-021-01177-0
M3 - Article
C2 - 34649563
AN - SCOPUS:85117512005
SN - 1756-8722
VL - 14
JO - Journal of Hematology and Oncology
JF - Journal of Hematology and Oncology
IS - 1
M1 - 168
ER -