Age, successive waves, immunization, and mortality in elderly COVID-19 hematological patients: EPICOVIDEHA findings

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • EPICOVIDEHA working group - (Author)
  • Department of Internal Medicine I
  • Brescia Civil Hospital
  • University of Cologne
  • Partner Site Bonn-Cologne
  • IRCCS Istituti fisioterapici ospitalieri - Istituto Regina Elena
  • Hospital Provincial de Ávila
  • Azienda Ospedaliera S. Luigi Gonzaga
  • Universidad Autónoma de Madrid
  • University of Copenhagen
  • Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E.
  • Centre Hospitalier de Versailles
  • Université de Versailles Saint-Quentin-en-Yvelines
  • Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo
  • Masaryk University
  • University Hospital Dubrava
  • University Hospital of Bellvitge
  • Autonomous University of Barcelona
  • ADRZ
  • University of Groningen
  • Vita-Salute San Raffaele University
  • University Hospital Hradec Králové
  • Fondazione IRCCS San Gerardo dei Tintori
  • University of Milan - Bicocca
  • NIHR Oxford Biomedical Research Centre (BRC)
  • University of Verona
  • University of Turin
  • AZ Sint-Jan Brugge-Oostende AV
  • Universidade Federal do Rio de Janeiro
  • AZ KLINA
  • Hospital Universitario Virgen del Rocio
  • IRCCS Fondazione Ca'Granda – Ospedale Maggiore Policlinico - Milano
  • University Hospital Centre Rijeka
  • University of Rijeka
  • Zealand University Hospital
  • University of Belgrade
  • A. Gemelli University Hospital Foundation IRCCS
  • Institut de Cancérologie Strasbourg Europe
  • Azienda Sanitaria Universitaria Integrata di Udine
  • Ospedale Dimiccoli Barletta
  • Karolinska Institutet
  • University of Insubria
  • Hospital General Universitario Gregorio Marañon
  • Hospital Universitario de Burgos
  • Puerta de Hierro University Hospital in Majadahonda
  • University of Hamburg
  • University of Parma
  • La Paz University Hospital
  • CIBER - Center for Biomedical Research Network
  • King's College London (KCL)
  • Hospital Clinic of Barcelona
  • Hospital Universitario Marques de Valdecilla
  • Cornell University
  • Hospital Complex of Navarra (HUN)
  • Batajnica COVID hospital
  • University of Szeged

Abstract

Objectives: Elderly patients with hematologic malignancies face the highest risk of severe COVID-19 outcomes. The infection's impact on different age groups remains unstudied in detail. Methods: We analyzed elderly patients (age groups: 65-70, 71-75, 76-80, and >80 years old) with hematologic malignancies included in the EPICOVIDEHA registry between January 2020 and July 2022. Univariable and multivariable Cox regression models were conducted to identify factors influencing death in COVID-19 patients with hematological malignancy. Results: The study included data from 3,603 elderly patients (aged 65 or older) with hematological malignancy, with a majority being male (58.1%) and a significant proportion having comorbidities. The patients were divided into four age groups, and the analysis assessed COVID-19 outcomes, vaccination status, and other variables in relation to age and pandemic waves. The 90-day survival rate for patients with COVID-19 was 71.2%, with significant differences between groups. The pandemic waves had varying impacts, with the first wave affecting patients over 80 years old, the second being more severe in 65-70, and the third being the least severe in all age groups. Factors contributing to 90-day mortality included age, comorbidities, lymphopenia, active malignancy, acute leukemia, less than three vaccine doses, severe COVID-19, and using only corticosteroids as treatment. Conclusion: These data underscore the heterogeneity of elderly hematological patients, highlight the different impacts of COVID-19 waves and the pivotal importance of vaccination, and may help in planning future healthcare efforts.

Details

Original languageEnglish
Pages (from-to)98-110
Number of pages13
JournalInternational journal of infectious diseases
Volume137
Publication statusPublished - Dec 2023
Peer-reviewedYes

External IDs

PubMed 37863310
ORCID /0000-0001-6022-6827/work/173054899

Keywords

Sustainable Development Goals

Keywords

  • COVID-19, Elderly, Hematological malignancy, High-risk patient, SARS-CoV-2