Hematologic Neoplasms As Risk Factor For Severe COVID-19: A Systematic Review Protocol

Abstract

Background: Patients with hematologic neoplasm may have compromised immunity due to their malignancy and/or treatment, and may be at elevated risk of severe COVID-19. However, the studies bring together patients with hematologic neoplasms and solid tumors into a single group, making no distinction about the types of hematological tumors and their treatments. This systematic review is designed to explore the risk of severe COVID-19 in patients with hematologic neoplasm. Studies about patients, adult or children, with hematologic neoplasm and COVID-19 will be included. Methods: A systematic review according to Joanna Briggs Institute methodology for systematic reviews of etiology and risk will be performed. The review will consider as participants adults or children with COVID-19 infection detected by RT-PCR or serology (SARS-CoV-2 antibody). We will be included studies without routine labs confirmation of COVID-19 if the patients presented clinical/physical exam and computed tomography suggesting COVID-19. The exposure of interest will be hematologic neoplasm, which include lymphomas, acute and chronic leukemias, myeloma, myelodysplastic syndrome, and myeloproliferative diseases. We will consider cohort, case-control, analytical cross-sectional studies. Outcomes among patients with COVID-19 are critical symptoms, hospitalizations, intensive care unit admissions, mechanical ventilation and deaths. We will exclude studies with other neoplasms than hematologic neoplasms. Search strategies have been created for the Embase, Medline and LILACS. Two reviewers independently will assess the studies for their eligibility, will extract data and will evaluate their risk of bias. Similar outcomes measured in at least two studies will be plotted in the meta-analysis using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information. Discussion: This systematic review aims to evaluate if patients with hematologic neoplasm may be at elevated risk of severe COVID-19. This review will differ from the previous ones because we will include controlled studies and groups with only hematologic neoplasm, excluding other cancers. The main hypothesis of our research is that not all hematological cancer patients have high risk of severe COVID-19. Trial registration number: PROSPERO CRD42020199318.