COVID-19 outcomes in patients with hematologic disease

Malard, Florent; Genthon, Alexis; Brissot, Éolia; Wyngaert, Zoé Van de; Marjanovic, Zora; Ikhlef, Souhila; Banet, Anne; Lapusan, Simona; Sestilli, Simona; Corre, Elise; Paviglianiti, Annalisa; Adaeva, Rosa; ’Hammedi-Bouzina, Fella M.; Labopin, Myriam; Legrand, Ollivier; Duléry, Rémy; Mohty, Mohamad

doi:10.1038/s41409-020-0931-4

Cited by 165 publications

(236 citation statements)

References 12 publications

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“…and we probably only collected the most severe cases. However it is concordant with other series (12), and con rmed that COVID-19 is severe for patients treated for a haematological disease. As already described we report a high frequency of patient with multiple myeloma.…”

Section: Discussionsupporting

confidence: 87%

How COVID-19 pandemic has changed haematological care

Fouquet

Franchi

Mittaine-Marzac

et al. 2020

Preprint

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Abstract Background : Datas from China suggest that patients with cancer have more severe outcome in case of covid-19 infection. Patients with haematological disease have often immunosuppression, due to the underlying disease and to their treatment. Methods: We recorded the consecutive patients usually treated in our haematology department diagnosed with COVID-19 infection between March 10th to April 30th. To evaluate the impact of the pandemic, we compare the activity of our department during two twenty working-days periods: March 20th to April 17th (“Covid month”) and February 18th to March 16th 2020 (“Covid-free month”). Results: Fifty patients treated in our haematology department had a COVID-19 infection, diagnosed with PCR or CT-scanner. Half of them were still on chemotherapy treatment, 30% were on survey after treatment and 20% were on a “watch and wait” strategy. Sixteen patients ( 30%) evolved to an acute respiratory syndrome with a fatal outcome in ten cases. (20%). The severity of the disease prompted us to change the organization of our department to protect our patients. We followed international recommendation and delayed non urgent procedure. this allowed a reduction of 10% of our activity. Moreover, we managed to treat 25% of our patients coming usually in outpatient clinic with tele-health. Thanks to hospital-at-home, these patients could receive their treatment and stay safe at home. Conclusion: This retrospective study give an insight of how covid-19 outbreak will change cancer care.

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Section: Discussionsupporting

confidence: 87%

How COVID-19 pandemic has changed haematological care

Fouquet

Franchi

Mittaine-Marzac

et al. 2020

Preprint

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“…To our knowledge, this is the rst large-scale case series describing the epidemiology and outcome of COVID-19 in patients with hematologic malignancies. To date, only small case series in this setting have been reported (14,15,21,22) in mainly hospitalized patients, whereas our study included both inpatients and outpatients. Our ndings show that patients with hematologic malignancies and COVID-19 have 3-4-fold higher rates of severe/critical disease (62% vs 15%) and mortality (33% vs 10%) compared to COVID-19 cases in the general population.…”

Section: Discussionmentioning

confidence: 99%

“…One showed very high mortality (40% at 1 month) among 25 patients in France. (14) A second suggested that hospitalized patients with hematologic malignancies have a higher mortality rate than patients without hematologic malignancies (62% vs 8%). (15) However, these were small patient series; the clinical impact of COVID-19 in this population remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study

García‐Suárez

Cruz

Cedillo

et al. 2020

Preprint

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Background Patients with cancer have been shown to have a higher risk of clinical severity and mortality compared to non-cancer patients with COVID-19. Patients with hematologic malignancies typically are known to have higher levels of immunosuppression and may develop more severe respiratory viral infections than patients with solid tumours. Data on COVID-19 in patients with hematologic malignancies are limited. Here we characterise disease severity and mortality, and evaluate potential prognostic factors for mortality.Methods In this population-based registry study, we collected de-identified data on clinical characteristics, treatment and outcomes in adult patients with hematologic malignancies and confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection within the Madrid region of Spain. Our case series included all patients admitted to 22 regional health service hospitals and 5 private healthcare centres between February 28 and May 25, 2020. The primary study outcome was all-cause mortality. We assessed the association between mortality and potential prognostic factors using Cox regression analyses adjusted for age, sex, comorbidities, hematologic malignancy and recent active cancer therapy.Results Of 833 patients reported, 697 were included in the analyses. Median age was 72 years (IQR 60–79), 413 (60%) patients were male, and 479 (69%) and 218 (31%) had lymphoid and myeloid malignancies, respectively. Clinical severity of COVID-19 was severe/critical in 429 (62%) patients. At data cutoff, 230 (33%) patients had died. Age ≥60 years (hazard ratios 3·17–10·1 vs <50 years), >2 comorbidities (1·41 vs ≤2), acute myeloid leukemia (2·22 vs non-Hodgkin lymphoma) and active antineoplastic treatment with monoclonal antibodies (2·02) or conventional chemotherapy (1·50 vs no active therapy) were associated with increased mortality. Conversely, Ph-negative myeloproliferative neoplasms (0·33) and active treatment with hypomethylating agents (0·47) were associated with lower mortality. Overall, 574 (82%) patients received antiviral therapy. Mortality with severe/critical COVID-19 was higher with no therapy vs any antiviral combination therapy (2.20).Conclusions In this series of patients with hematologic malignancies and COVID-19, mortality was associated with higher age, more comorbidities, type of hematological malignancy and type of antineoplastic therapy. Further studies and long-term follow-up are required to validate these criteria for risk-stratification.

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“…Patients with compromised immune systems are at increased risk of complications of COVID‐19 but this risk is not precisely defined 2 . Although age, gender, comorbidities and ethnicity are risk factors for adverse outcomes, 3 various pre‐existing conditions, including haematological cancers, have also been reported to correlate with poor outcomes 4–8 …”

Section: Figurementioning

confidence: 99%