COVID‐19 in patients with hematological malignancies: A retrospective case series

Abstract

Since its first identification in China in December 2019, several reports have been published describing epidemiological and clinical characteristics of patients with COVID-19, with an overall mortality rate ranging from 1.4% to 2.3%, that can increase up to 22.4%-24.5% in hospitalized patients. 2,3 Patients with cancer have a higher susceptibility to infections due to their immunosuppression state caused by the malignancy itself or by antineoplastic treatments. Specifically, infections caused by community respiratory viruses had been associated with poor outcome in patients with hematological malignancies. Few data are available on hematologic patients and COVID-19 infection, with discordant results, probably due to the small sample size of the studies. To date, these data come from retrospective clinical case series 4-9 from different countries in which case fatality rates (CFR) range from 33% to 62%. Mortality has been associated, depending on the published series, with age, comorbidities, active hematological disease, intensive treatment, or some laboratory variables. Thus, more data are required to better characterize the real impact of COVID-19 in patients with hematological neoplasms, in order to optimize clinical decision-making. We carried out a single-center analysis of 41 consecutive patients with hematological malignancies who developed COVID-19 between March 8 and

COVID-19 in 96 Patients With Hematologic Disease: The First Single-center Experience From the Czech Republic

“…In studies of adult patients with hematologic malignancies, the median age ranges from 50 to 76 years of age, reflecting both the generally higher prevalence of malignancies at older age and the more severe course of COVID-19. 4 , 5 , 6 , 17 A similar trend was seen in our study, with a median age of 66 years and high proportions of patients who did not achieve remission of their hematologic disease (69/96 [71.9%]) or those undergoing cancer treatment (75/96 [78.1%]).…”

“…In a study of 41 patients with hematologic malignancies by Infante et al, 6 nosocomial transmission of SARS-CoV-2 was confirmed in 5 patients (15%) and seemed likely in 25 patients who had attended the hospital in the previous 14 days. Moreover, Elkrief et al 23 , 24 showed that patients with health care–associated COVID-19 infection had a significantly worse prognosis.…”

“…Lymphoproliferative disorders account for 55% to 91% malignancies in studies. 5 , 6 , 7 , 17 The high proportions may be explained by the higher immunosuppressant potential of therapies (including frequently used monoclonal antibodies) for these conditions as compared with chronic myeloproliferative disorders typically associated with a less complicated course and lower mortality rates. 7 , 17 The present study found lymphoproliferative disorders in as many as 67.7% of cases and a generally milder course of COVID-19 was observed in patients with selected myeloproliferative disorders.…”

“… 2 , 3 Published studies report significantly higher mortality associated with COVID-19 in patients with hematologic malignancies older than 60 years and those not achieving a complete remission (CR) of their disease. 4 , 5 , 6 The groups most at risk are patients with acquired bone marrow failure and acute leukemia who were found to have higher infection fatality rates than those with lymphoproliferative disorders. 4 , 7 In addition to the infection fatality rate, another important measure used to assess the impact of the COVID-19 pandemic on hematologic patients will be cancer fatality rate, reflecting delays in cancer treatment owing to infectious complications.…”

The impact of biosafety enhancement on stat laboratory quality metrics: Lessons from the COVID-19 pandemic

“…Since stat laboratories often serve a high fraction of patients with co-morbidities such as age > 60 years and cancer, which have been associated with severe disease and poor prognosis in SARS-CoV-2 infection [3] , [4] , [5] , [6] , it is essential for these laboratories to support their clinical services in a way to minimize patient wait times and still maintain acceptable quality. The purpose of this study was to examine the outcomes, as measured by quality metrics, of the policies implemented by a stat laboratory operating in a hematology/oncology outpatient clinic, in response to the COVID-19 pandemic.…”