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

Medientyp: E-Artikel
Titel: COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA)
Beteiligte: Pagano, Livio; Salmanton-García, Jon; Marchesi, Francesco; Busca, Alessandro; Corradini, Paolo; Hoenigl, Martin; Klimko, Nikolai; Koehler, Philipp; Pagliuca, Antonio; Passamonti, Francesco; Verga, Luisa; Víšek, Benjamin; Ilhan, Osman; Nadali, Gianpaolo; Weinbergerová, Barbora; Córdoba-Mascuñano, Raúl; Marchetti, Monia; Collins, Graham P.; Farina, Francesca; Cattaneo, Chiara; Cabirta, Alba; Gomes-Silva, Maria; Itri, Federico; van Doesum, Jaap; [...]
Erschienen: Springer Science and Business Media LLC, 2021
Erschienen in: Journal of Hematology & Oncology
Sprache: Englisch
DOI: 10.1186/s13045-021-01177-0
ISSN: 1756-8722
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Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>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.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>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.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma <jats:italic>n</jats:italic> = 1084, myeloma <jats:italic>n</jats:italic> = 684 and chronic lymphoid leukemia <jats:italic>n</jats:italic> = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia <jats:italic>n</jats:italic> = 497 and myelodysplastic syndromes <jats:italic>n</jats:italic> = 279). Severe/critical COVID-19 was observed in 63.8% of patients (<jats:italic>n</jats:italic> = 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%, <jats:italic>p</jats:italic> 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.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>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.</jats:p> </jats:sec>
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