Clinical characteristics and risk factors associated with nosocomial COVID-19 infection in patients with hematological disorders in Japan

Abstract

Patients with cancer are considered at high risk of acquiring coronavirus disease (COVID-19). To identify patients who are likely to be diagnosed with severe COVID-19, we analyzed the risk factors for mortality in patients admitted to the hematology department at our institute. The mortality rate of all patients was as high as 62% (21 of the 34 patients), and most of these patients had malignant malignancies. Patients before an achievement of remission had a 10.8-fold higher risk of death than those in remission. The group receiving chemotherapy with steroids had a shorter survival time and had an 8.3-fold higher risk of death than that receiving chemotherapy without steroids. During the COVID-19 pandemic, it is necessary to carefully monitor or follow-up patients with active diseases and patients receiving steroid-containing chemotherapy.

Persistent viral shedding of severe acute respiratory syndrome coronavirus 2 after treatment with bendamustine and rituximab: A case report

“…The favorable outcomes in these cases were attributed to the successful treatment of hematological malignancies. Previous studies indicate that certain risk factors confer poor prognosis in COVID-19 patients with hematological disorders; these include active hematological disorders that are not in remission, receiving chemotherapy with steroids, age >70 years, and treatment with bendamustine within 12 months [ 2 , 9 ]. However, the patients in the reported cases had several of these risk factors; most improved because their underlying diseases were in remission.…”

COVID-19 Cluster in the Hematology/Respirology Ward of a University Hospital during the Seventh Wave of the SARS-CoV-2 Pandemic in Japan: A Descriptive Study

“…SARS-CoV-2 was first recognized in an outbreak of pneumonia in Wuhan, Hubei Province, China, in December 2019 ( 8 ). In March 2020, 4 months after the initial outbreak in Wuhan, a large cluster of nosocomial SARS-CoV-2 infections occurred at the Eiju General Hospital in Tokyo ( 1 , 9 , 10 ), involving 109 inpatients and 83 healthcare workers (according to the final report from the Eiju General Hospital issued on May 16, 2020). In a detailed study ( 10 ), the mortality rate was strikingly high in patients with hematological diseases (19/31, 61%).…”

“…In March 2020, 4 months after the initial outbreak in Wuhan, a large cluster of nosocomial SARS-CoV-2 infections occurred at the Eiju General Hospital in Tokyo ( 1 , 9 , 10 ), involving 109 inpatients and 83 healthcare workers (according to the final report from the Eiju General Hospital issued on May 16, 2020). In a detailed study ( 10 ), the mortality rate was strikingly high in patients with hematological diseases (19/31, 61%). Patients with hematological malignancies reportedly tend to have a more severe COVID-19 trajectory than do those with solid organ tumors or other diseases ( 11 , 12 ).…”

Advanced palliative care medicine in hematological oncology

“…Lastly, we advocate the importance of end-of-life (EOL) care in hemato-oncology patients, particularly in the advent of the worldwide pandemic, because during the COVID-19 era, EOL care is highlighted due to the high risk of morbidity and mortality; therefore, extreme precaution is required for these populations. Patients diagnosed with hematological diseases complicated by COVID-19 often have a poor prognosis, not only because of the COVID-19 infection but also due to their hematological comorbidity (11). The mortality rate was as high as 62% (11) in Japanese patients with hematological diseases.…”

“…Patients diagnosed with hematological diseases complicated by COVID-19 often have a poor prognosis, not only because of the COVID-19 infection but also due to their hematological comorbidity (11). The mortality rate was as high as 62% (11) in Japanese patients with hematological diseases. This is from inpatient setting data.…”