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.
COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA) / L. Pagano, J. Salmanton-Garcia, F. Marchesi, A. Busca, P. Corradini, M. Hoenigl, N. Klimko, P. Koehler, A. Pagliuca, F. Passamonti, L. Verga, B. Visek, O. Ilhan, G. Nadali, B. Weinbergerova, R. Cordoba-Mascunano, M. Marchetti, G.P. Collins, F. Farina, C. Cattaneo, A. Cabirta, M. Gomes-Silva, F. Itri, J. van Doesum, M.-. Ledoux, M. Cernan, O. Jaksic, R.F. Duarte, G. Magliano, A.S. Omrani, N.S. Fracchiolla, A. Kulasekararaj, T. Valkovic, C.B. Poulsen, M. Machado, A. Glenthoj, I. Stoma, Z. Racil, K. Piukovics, M. Navratil, Z. Emarah, U. Sili, J. Maertens, O. Blennow, R. Bergantim, C. Garcia-Vidal, L. Prezioso, A. Guidetti, M.I. del Principe, M. Popova, N. de Jonge, I. Ormazabal-Velez, N. Fernandez, I. Falces-Romero, A. Cuccaro, S. Meers, C. Buquicchio, D. Antic, M. Al-Khabori, R. Garcia-Sanz, M.M. Biernat, M.C. Tisi, E. Sal, L. Rahimli, N. Colovic, M. Schonlein, M. Calbacho, C. Tascini, C. Miranda-Castillo, N. Khanna, G.-. Mendez, V. Petzer, J. Novak, C. Besson, R. Dulery, S. Lamure, M. Nucci, G. Zambrotta, P. Zak, G.C. Seval, V. Bonuomo, J. Mayer, A. Lopez-Garcia, M.V. Sacchi, S. Booth, F. Ciceri, M. Oberti, M. Salvini, M. Izuzquiza, R. Nunes-Rodrigues, E. Ammatuna, A. Obr, R. Herbrecht, L. Nunez-Martin-Buitrago, V. Mancini, H. Shwaylia, M. Sciume, J. Essame, M. Nygaard, J. Batinic, Y. Gonzaga, I. Regalado-Artamendi, L.K. Karlsson, M. Shapetska, M. Hanakova, S. El-Ashwah, Z. Borbenyi, G.M. Colak, A. Nordlander, G. Dragonetti, A.M.E. Maraglino, A. Rinaldi, C. De Ramon-Sanchez, O.A. Cornely, O. Finizio, R. Fazzi, G. Sapienza, A. Chauchet, J. Van Praet, J. Prattes, M. Dargenio, C. Rossi, A. Shirinova, S. Malak, A. Tafuri, H.-. Ommen, S. Bologna, R.A. Khedr, S. Choquet, B. Joly, M.M. Ceesay, L. Philippe, C.S. Kho, M. Desole, P. Tsirigotis, V. Otasevic, D.M.M. Borducchi, A. Antoniadou, J. Gaziev, M.A. Almaslamani, N. Garcia-Pouton, G. Paterno, A. Torres-Lopez, G. Tarantini, S. Mellinghoff, S. Grafe, N. Borschel, J. Passweg, M. Merelli, A. Barac, D. Wolf, M.U. Shaikh, C. Thieblemont, S. Bernard, V.A.M. Funke, E. Daguindau, S. Khostelidi, F.M. Nucci, J.-. Martin-Gonzalez, M. Landau, C. Soussain, C. Laureana, K. Lacombe, M. Kohn, G. Aliyeva, M. Piedimonte, G. Fouquet, M. Rego, B. Hoell-Neugebauer, G. Cartron, F. Pinto, A.M. Alburquerque, J. Passos, A.F. Yilmaz, A.-. Redondo-Izal, F. Altuntas, C. Heath, M. Kolditz, E. Schalk, F. Guolo, M. Karthaus, R. Della Pepa, D. Vinh, N. Noel, B. Deau Fischer, B. Drenou, M.E. Mitra, J. Meletiadis, Y.M. Bilgin, P. Jindra, I. Espigado, L. Drgona, A. Serris, R. Di Blasi, N. Ali. - In: JOURNAL OF HEMATOLOGY & ONCOLOGY. - ISSN 1756-8722. - 14:1(2021 Oct 14), pp. 168.1-168.15. [10.1186/s13045-021-01177-0]
COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA)
P. Corradini;F. Passamonti;A. Guidetti;
2021
Abstract
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.
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