COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA)
Research output: Contribution to journal › Research article › Contributed › peer-review
Contributors
- Department of internal Medicine 3
- Chair of Textile Technology
- American Society of Hematology
- German Sport University Cologne
- IRCCS Regina Elena National Cancer Institute
- Stem Cell Transplant Center
- University of Milan and Fondazione IRCCS Istituto Nazionale Dei Tumori
- University of California at San Diego
- North-Western State Medical University named after I.I. Mechnikov
- Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD)
- Excellence Center for Medical Mycology (ECMM)
- CECAD Research Center
- King's College Hospital NHS Foundation Trust
- University of Insubria
- Azienda Ospedaliera San Gerardo Monza
- University Hospital Hradec Králové
- Ankara University
- Policlinico Borgo Roma Verona
- University Hospital Brno
- Fundacion Jimenez Díaz University Hospital
- Hematology and BMT Unit
- Churchill Hospital
- IRCCS Hospital San Raffaele
- ASST-Spedali Civili
- Azienda Ospedaliera S. Luigi Gonzaga
- University Medical Center Groningen
- Institut de Cancérologie Strasbourg Europe
- Palacký University Olomouc
- University Hospital Dubrava
- Puerta de Hierro University Hospital in Majadahonda
- ASST Grande Ospedale Metropolitano Niguarda
- Communicable Disease Center
- IRCCS Fondazione Ca'Granda – Ospedale Maggiore Policlinico - Milano
- University Hospital Centre Rijeka
- Sjællands Universitetshospital
- Hospital General Universitario Gregorio Marañon
- Rigshospitalet
- Gomel State Medical University
- University of Szeged
- University Hospital Ostrava
- Mansoura University
- Marmara University
- KU Leuven
- Karolinska University Hospital
- University of Porto
- University of Bonn Medical Center
- U.O. Ematologia E Centro Trapianti Midollo Osseo
- IRCCS Fondazione Istituto Nazionale per lo studio e la cura dei tumori - Milano
- University of Rome Tor Vergata
- Pavlov First State Medical University of St. Petersburg
- Masaryk University
Abstract
BACKGROUND: Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality.
METHODS: The survey was supported by the Scientific Working Group Infection in Hematology of the European Hematology Association (EHA). Eligible for the analysis were adult patients with HM and laboratory-confirmed COVID-19 observed between March and December 2020.
RESULTS: The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma n = 1084, myeloma n = 684 and chronic lymphoid leukemia n = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia n = 497 and myelodysplastic syndromes n = 279). Severe/critical COVID-19 was observed in 63.8% of patients (n = 2425). Overall, 2778 (73.1%) of the patients were hospitalized, 689 (18.1%) of whom were admitted to intensive care units (ICUs). Overall, 1185 patients (31.2%) died. The primary cause of death was COVID-19 in 688 patients (58.1%), HM in 173 patients (14.6%), and a combination of both COVID-19 and progressing HM in 155 patients (13.1%). Highest mortality was observed in acute myeloid leukemia (199/497, 40%) and myelodysplastic syndromes (118/279, 42.3%). The mortality rate significantly decreased between the first COVID-19 wave (March-May 2020) and the second wave (October-December 2020) (581/1427, 40.7% vs. 439/1773, 24.8%, p value < 0.0001). In the multivariable analysis, age, active malignancy, chronic cardiac disease, liver disease, renal impairment, smoking history, and ICU stay correlated with mortality. Acute myeloid leukemia was a higher mortality risk than lymphoproliferative diseases.
CONCLUSIONS: This survey confirms that COVID-19 patients with HM are at high risk of lethal complications. However, improved COVID-19 prevention has reduced mortality despite an increase in the number of reported cases.
Details
| Original language | English |
|---|---|
| Pages (from-to) | 168 |
| Journal | Journal of hematology & oncology |
| Volume | 14 |
| Issue number | 1 |
| Publication status | Published - 14 Oct 2021 |
| Peer-reviewed | Yes |
External IDs
| PubMedCentral | PMC8515781 |
|---|---|
| Scopus | 85117512005 |
Keywords
Keywords
- Adult, Aged, Aged, 80 and over, COVID-19/complications, Europe/epidemiology, Female, Hematologic Neoplasms/complications, Hospitalization, Humans, Intensive Care Units, Male, Middle Aged, Registries, Risk Factors, SARS-CoV-2/isolation & purification, Young Adult