The impact of COVID-19 on the provision of donor hematopoietic stem cell products worldwide: collateral damage

Szer, Jeffrey; Weisdorf, Daniel J.; Querol, Sergio; Foeken, Lydia; Madrigal, Alejandro

doi:10.1038/s41409-020-0873-x

Cited by 36 publications

(40 citation statements)

References 4 publications

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“…The clinical characteristics, management, and outcome of COVID-19 in patients undergoing HSCT remain unknown; guidelines are being generated by various organisations. (29,30) Our real-world data showed a mortality rate of 18%. However, this gure should be interpreted with caution as both type of transplant and time from transplant (IQR 8-56 months) were heterogeneous.…”

Section: Discussionmentioning

confidence: 75%

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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Section: Discussionmentioning

confidence: 75%

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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“…Worldwide, insecurity and anxiety of being infected by SARS‐CoV‐2 along with measures of social isolation largely prevent blood donations 49 . Similarly, the pandemic crisis may hinder the donation of hematopoietic stem cells, as well 50 . However, the need for stem cell donors will remain constant and the need for blood donor will probably increase in order to support the critically ill COVID‐19 patients.…”

Section: Resultsmentioning

confidence: 99%

Hematological findings and complications of COVID‐19

Terpos

Ntanasis‐Stathopoulos

et al. 2020

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COVID-19 is a systemic infection with a significant impact on the hematopoietic system and hemostasis. Lymphopenia may be considered as a cardinal laboratory finding, with prognostic potential. Neutrophil/lymphocyte ratio and peak platelet/lymphocyte ratio may also have prognostic value in determining severe cases. During the disease course, longitudinal evaluation of lymphocyte count dynamics and inflammatory indices, including LDH, CRP and IL-6 may help to identify cases with dismal prognosis and prompt intervention in order to improve outcomes. Biomarkers, such high serum procalcitonin and ferritin have also emerged as poor prognostic factors. Furthermore, blood hypercoagulability is common among hospitalized COVID-19 patients. Elevated D-Dimer levels are consistently reported, whereas their gradual increase during disease course is particularly associated with disease worsening. Other coagulation abnormalities such as PT and aPTT prolongation, fibrin degradation products increase, with severe thrombocytopenia lead to life-threatening disseminated intravascular coagulation (DIC), which necessitates continuous vigilance and prompt intervention. So, COVID-19 infected patients, whether hospitalized or ambulatory, are at high risk for venous thromboembolism, and an early and prolonged pharmacological thromboprophylaxis with low molecular weight heparin is highly recommended. Last but not least, the need for assuring blood donations during the pandemic is also highlighted.

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“…Moreover, resources at blood banks have been depleted due to decreased donating and the increase in the need from patients with COVID‐19. Reallocation of hospital resources are other concerns policymakers must contend with 15 …”

Section: Discussionmentioning

confidence: 99%

Performing gynecologic cancer surgery during the COVID‐19 pandemic in Turkey: A multicenter retrospective observational study

Dursun¹,

Dervişoğlu

Dağgez

et al. 2020

Intl J Gynecology & Obste

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Objective To report the perioperative outcomes of 200 patients with gynecologic cancer who underwent surgery during the Novel Coronavirus Disease (COVID‐19) pandemic and the safety of surgical approach. Methods Data of patients operated between March 10 and May 20, 2020, were collected retrospectively. Data were statistically analyzed using IBM Statistical Package for the Social Sciences (SPSS) Statistics for Windows v. SP21.0. Results Data of 200 patients were included. Their mean age was 56 years. Of the patients, 54% (n=108), 27.5% (n=55), 12.5% (n=25), and 2% (n=4) were diagnosed as having endometrial, ovarian, cervical, and vulvar cancer, respectively. Of them, 98% underwent non‐emergent surgery. A minimally invasive surgical approach was used in 18%. Stage 1 cancer was found in 68% of patients. Surgeons reported COVID‐related changes in 10% of the cases. The rate of postoperative complications was 12%. Only two patients had cough and suspected pneumonic lesions on thoracic computed tomography postoperatively, but neither was positive for COVID‐19 on polymerase chain reaction testing. Conclusion Based on the present findings, it is thought that gynecologic cancer surgery should continue during the COVID‐19 pandemic while adhering to the measures. Postponement or non‐surgical management should only be considered in patients with documented infection. Gynecologic cancer surgery should continue during the COVID‐19 pandemic while adhering to measures. Only 1% of patients developed COVID‐19‐related symptoms during the postoperative follow‐up period.

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The impact of COVID-19 on the provision of donor hematopoietic stem cell products worldwide: collateral damage

Cited by 36 publications

References 4 publications

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

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

Hematological findings and complications of COVID‐19

Performing gynecologic cancer surgery during the COVID‐19 pandemic in Turkey: A multicenter retrospective observational study

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