Introduction In this study, we aim to report the outcome of COVID‐19 in patients with hematological malignancy in Turkey. Method The data of laboratory‐confirmed 188,897 COVID‐19 patients diagnosed between March 11, 2020 and June 22, 2020 included in the Republic of Turkey, Ministry of Health database were analyzed retrospectively. All of the COVID‐19 patients with hematological malignancy (n=740) were included in the study and an age, gender and comorbidity matched COVID‐19 patients without cancer (n=740) at 1:1 ratio was used for comparison. Results Non Hodgkin lymphoma (30.1%), myelodysplastic syndrome (19.7%), myeloproliferative neoplasm (15.7%), were the most common hematological malignancies. The rates of severe and critical disease were significantly higher in patients with hematological malignancy compared to the patients without cancer (p=0.001). The rates of hospital and intensive care unit (ICU) admission were higher in patients with hematological malignancy compared to the patients without cancer (p=0.023, p=0.001, respectively). The length of hospital stay and ICU stay were similar between groups (p=0.7, p=0.3; retrospectively). The rate of mechanical ventilation (MV) support was higher in patients with hematological malignancy compared to the control group (p=0.001). The case fatality rate (CFR) was 13.8% in patients with hematological malignancy, and it was 6.8% in the control group (p=0.001). Conclusion This study reveals that there is an increased risk of COVID‐19 related serious events (ICU admission, MV support or death) in patients with hematological malignancy compared to COVID‐19 patients without cancer and supports high vulnerability of patients with hematological malignancy in the current pandemic. This article is protected by copyright. All rights reserved.
Background: Diagnosis and screening of frailty, a condition characterized by an increased vulnerability to adverse outcomes of COVID-19, has emerged as an essential clinical tool which is strongly recommended by healthcare providers concerned with hospitalized elderly population. The data showing the role of frailty in patients infected with COVID-19 is needed. Methods: This was a nationwide cohort study conducted at all hospitals in Turkey. All COVID-19 hospitalized patients (≥ 65 years) were included. Patients who were alive and not discharged up to July 20, 2020, were excluded. The frailty was assessed by using the "Hospital Frailty Risk Score" (HFRS). Patients were classified into three risk groups of frailty based on previously validated cut points as low (< 5 points), intermediate (5-15 points), and high (> 15 points). Additionally, patients who had the HFRS of ≥5 were defined as frail. The primary outcome was in-hospital mortality rates by frailty group.
In this study, we aim to report the outcome of COVID-19 in hematopoietic cell transplant (HCT) recipients. HCT recipients (n = 32) with hematological disease and hospitalized for COVID-19 were included in the study. A cohort of age and comorbid disease-matched hospitalized COVID-19 patients with hematological malignancy but not underwent HCT (n = 465), and another cohort of age and comorbid disease-matched hospitalized COVID-19 patients without cancer (n = 497) were also included in the study for comparison. Case fatality rate (CFR) was 5.6% in patients without cancer, 11.8 in patients with hematological malignancy and 15.6% in HCT recipients. The CFR in HCT recipients who were not receiving immunosuppressive agents at the time of COVID-19 diagnosis was 11.5%, whereas it was 33% in HCT recipients who were receiving an immunosuppressive agent at the time of COVID-19 diagnosis. In conclusion, our study reveals that for the current pandemic, HCT recipients, especially those receiving immunosuppressive drugs, constitute a special population of cancer patients.
Introduction In this study, we aim to report the outcome of COVID-19 in chronic myeloid leukemia (CML) patients receiving tyrosine kinase inhibitor (TKI). Method The data of 16 laboratory-confirmed COVID-19 patients with CML receiving TKI and age, gender, and comorbid disease matched COVID-19 patients without cancer at a 3/1 ratio (n = 48), diagnosed between March 11, 2020 and May 22, 2020 and included in the Republic of Turkey, Ministry of Health database, were analyzed retrospectively. Results The rates of intensive care unit (ICU) admission, and mechanical ventilation (MV) support were lower in CML patients compared to the control group, however, these differences did not achieve statistical significance (p = 0.1, and p = 0.2, respectively). The length of hospital stay was shorter in CML patients compared with the control group; however, it was not statistically significant (p = 0.8). The case fatality rate (CFR) in COVID-19 patients with CML was 6.3%, and it was 12.8% in the control group. Although the CFR in CML patients with COVID-19 was lower compared to the control group, this difference did not achieve statistical significance (p = 0.5). When CML patients were divided into 3 groups according to the TKI, no significant difference was observed regarding the rate of ICU admission, MV support, CFR, the length of stay in both hospital and ICU (all p > 0.05). Conclusion This study highlights that large scale prospective and randomized studies should be conducted in order to investigate the role of TKIs in the treatment of COVID-19.
Background A novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) occurred in China in December 2019 and has spread globally. In this study we aimed to describe the clinical characteristics and outcomes of hospitalized older adults with coronavirus disease 2019 (COVID-19) in Turkey. Methods We retrospectively analyzed the clinical data of hospitalized patients aged ≥ 60 years with confirmed COVID-19 from March 11, 2020, to May 27, 2020 using nationwide health database. Results In this nationwide cohort, a total of 16942 hospitalized older adults with COVID-19 were enrolled, of whom 8635 (51%) were women. Mean age was 71.2 ± 8.5 years, ranging from 60 to 113 years. Mortality rate before and after curfew was statistically different (32.2% vs 17.9%; p & 0.001, respectively). Through multivariate analysis of the causes of death in older patients, we found that male gender, diabetes mellitus, heart failure, chronic kidney disease, dementia, cancer, admission to intensive care unit, computed tomography finding compatible with COVID-19 were all significantly associated with mortality in entire cohort. In addition to abovementioned risk factors, in patients aged between 60-79 years, coronary artery disease, oxygen support need, total number of drugs, and cerebrovascular disease during hospitalization, and in patients 80 years of age and older acute coronary syndrome during hospitalization were also associated with increased risk of mortality. Conclusions In addition to the results of previous studies with smaller sample size, our results confirmed the age-related relationship between specific comorbidities and COVID-19 related mortality.
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