COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA)

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  • Livio Pagano
  • Jon Salmanton-García
  • Francesco Marchesi
  • Alessandro Busca
  • Paolo Corradini
  • Martin Hoenigl
  • Nikolai Klimko
  • Philipp Koehler
  • Antonio Pagliuca
  • Francesco Passamonti
  • Luisa Verga
  • Benjamin Víšek
  • Osman Ilhan
  • Gianpaolo Nadali
  • Barbora Weinbergerová
  • Raúl Córdoba-Mascuñano
  • Monia Marchetti
  • Graham P. Collins
  • Francesca Farina
  • Chiara Cattaneo
  • Alba Cabirta
  • Maria Gomes-Silva
  • Federico Itri
  • Jaap van Doesum
  • Marie Pierre Ledoux
  • Martin Čerňan
  • Ozren Jakšić
  • Rafael F. Duarte
  • Gabriele Magliano
  • Ali S. Omrani
  • Nicola S. Fracchiolla
  • Austin Kulasekararaj
  • Toni Valković
  • Poulsen, Christian Bjørn
  • Marina Machado
  • Glenthøj, Andreas Birkedal
  • Igor Stoma
  • Zdeněk Ráčil
  • Klára Piukovics
  • Milan Navrátil
  • Ziad Emarah
  • Uluhan Sili
  • Johan Maertens
  • Ola Blennow
  • Rui Bergantim
  • Carolina García-Vidal
  • Lucia Prezioso
  • Anna Guidetti
  • Maria Ilaria del Principe
  • Marietta Nygaard
  • EPICOVIDEHA working group

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.

OriginalsprogEngelsk
Artikelnummer168
TidsskriftJournal of Hematology and Oncology
Vol/bind14
Udgave nummer1
ISSN1756-8722
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
EPICOVIDEHA has received funds from Optics COMMITTM (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223).

Publisher Copyright:
© 2021, The Author(s).

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