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. 2020 Nov;105(5):597-607.
doi: 10.1111/ejh.13493. Epub 2020 Aug 11.

Clinical course and risk factors for mortality from COVID-19 in patients with haematological malignancies

José María Sanchez-Pina  1 , Mario Rodríguez Rodriguez  1 , Nerea Castro Quismondo  1 , Rodrigo Gil Manso  1 , Rafael Colmenares  1 , Daniel Gil Alos  1 , Mari Liz Paciello  1 , Denis Zafra  1 , Cristina Garcia-Sanchez  1 , Carolina Villegas  1 , Clara Cuellar  1 , Gonzalo Carreño-Tarragona  1 , Irene Zamanillo  1 , María Poza  1 , Rodrigo Iñiguez  1 , Xabier Gutierrez  1 , Rafael Alonso  1 , Antonia Rodríguez  1 , Maria Dolores Folgueira  2 , Rafael Delgado  2 , José Miguel Ferrari  3 , Manuel Lizasoain  4 , José María Aguado  4 , Rosa Ayala  1 , Joaquín Martinez-Lopez  1 , María Calbacho  1
Affiliations

Clinical course and risk factors for mortality from COVID-19 in patients with haematological malignancies

José María Sanchez-Pina et al. Eur J Haematol. 2020 Nov.

Abstract

Background: The impact of coronavirus disease 2019 (COVID-19) in haematological patients (HP) has not been comprehensively reported.

Methods: We analysed 39 patients with SARS-CoV-2 infection and haematological malignancies. Clinical characteristics and outcomes were compared to a matched control group of 53 non-cancer patients with COVID-19. Univariate and multivariate analyses were carried out to assess the risk factors associated with poor outcome.

Results: The most frequent haematological diseases were lymphoma (30%) and multiple myeloma (30%). Eighty-seven % HP developed moderate or severe disease. Patients with haematological malignancies had a significantly higher mortality rate compared to non-cancer patients (35.9% vs 13.2%; P = .003 (odds ratio 6.652). The worst outcome was observed in chronic lymphocytic leukaemia patients. Only age >70 years and C reactive protein >10 mg/dl at admission were associated with higher risk of death (odds ratio 34.86, P = .003 and 13.56,P = .03). Persistent viral sheddind was detected in 5 HP. Active chemotherapy, viral load at diagnosis and COVID-19 therapy were not predictors of outcome.

Conclusion: Mortality of COVID-19 is significantly higher in patients with haematological malignancies compared to non-cancer patients. The impact of persistent viral shedding must be considered in order to re-start therapies and maintain infectious control measures.

Keywords: COVID-19; SARS-CoV-2; cancer; haematology; outcome.

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References

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