COVID-19 in hematology: data from a hematologic and transplant unit

Abstract

During the COVID-19 pandemic, special attention has been addressed in cancer care to mitigate the impact on the patient’s prognosis. We addressed our preparation to face COVID-19 pandemic in a Hematological and Stem Cell Transplant Unit in Brazil during the first two months of COVID-19 pandemic and described COVID-19 cases in patients and health care workers (HCW). Modifications in daily routines included a separation of area and professionals, SARS-CoV-2 screening protocols, and others. A total of 47 patients and 54 HCW were tested for COVID-19, by PCR-SARS-CoV-2. We report 11 cases of COVID-19 in hematological patients (including 2 post stem cell transplant) and 28 cases in HCW. Hematological cases were most severe or moderate and presented with several poor risk factors. Among HCW, COVID-19 were mostly mild, and all recovered without hospitalization. A cluster was observed among HCW. Despite a decrease in the number of procedures, the Transplant Program performed 8 autologous and 4 allogeneic SCT during the period, and 49 onco-hematological patients were admitted to continuing their treatments. Although we observed a high frequency of COVID-19 among patients and HCW, showing that SARS-CoV-2 is disseminated in Brazil, hematological patients were safely treated during pandemic times.

Cuidados a criança com câncer frente a pandemia de COVID-19: Revisão integrativa da literatura

“…Segundo Garnica et al, (2020) o mundo enfrentando a pandemia de COVID-19 e as preocupações com os pacientes hematológicos foram abordadas, pois o diagnóstico de leucemia aguda ou crônica, linfoma, mieloma múltiplo ainda está sendo feito, e os pacientes devem continuar seus tratamentos para manter a resposta positiva e um bom prognóstico. Existem poucos relatos sobre pacientes hematológicos com COVID-19, mais o câncer hematológico prejudica o sistema imunológico devido o esquema de tratamento, e a infecção por COVID-19 poderia impactar o prognóstico.…”

“…Recomendações internacionais e nacionais foram referências para as ações deste estudo (Garnica et al, 2020), assim como relatórios de outros centros de transplante que já enfrentaram COVID-19. Modificações de cuidados incluíram pacientes internados e ambulatoriais, no momento de indicação do transplante, em transfusões de células sanguíneas e unidade de terapia intensiva.…”

“…Essa experiência citada no estudo de Garnica et al, (2020) que aconteceu durante os meses iniciais da pandemia de COVID-19 destacou algumas observações: COVID-19 se apresenta como casos moderados ou graves em pacientes oncohematológicos, e a mortalidade foi alta. Pacientes tratados com alta intensidade ou aqueles com comorbidades estavam em pior risco de COVID grave.…”

Implemented Interventions at the Naef K. Basile Cancer Institute to Protect Patients and Medical Personnel From COVID Infections: Effectiveness and Patient Satisfaction

“…The receipt of chemotherapy or cancer surgery was shown to be a risk factor for ICU admissions, intensive ventilation and death in COVID-19 patients (8). However, many oncology patients are postponing their clinic visits and treatment sessions due to fear of contracting the virus in overcrowded areas of the hospitals, which may hinder their care and treatment plans (9,10).…”

“…Modifications in staff operations include reducing the number of personnel in the medical team visiting the patients, emphasizing the use of PPE, appropriate hand hygiene and disinfection (4,5,10)…”