Risk Factors and Mortality of COVID-19 in Patients With Lymphoma: A Multicenter Study

Abstract

Patients with cancer are poorly represented in coronavirus disease 2019 (COVID-19) series, and heterogeneous series concerning hematology patients have been published. This study aimed to analyze the impact of COVID-19 in patients with lymphoma. We present a multicenter retrospective study from 19 centers in Madrid, Spain, evaluating risk factors for mortality in adult patients with COVID-19 and lymphoma. About 177 patients (55.9% male) were included with a median follow-up of 27 days and a median age of 70 years. At the time of COVID-19 diagnosis, 49.7% of patients were on active treatment. The overall mortality rate was 34.5%. Age >70 years, confusion, urea concentration, respiratory rate, blood pressure, and age >65 score ≥2, heart disease, and chronic kidney disease were associated with higher mortality risk (P < 0.05). Active disease significantly increased the risk of death (hazard ratio, 2.43; 95% confidence interval, 1.23-4.77; P = 0.01). However, active treatment did not modify mortality risk and no differences were found between the different therapeutic regimens. The persistence of severe acute respiratory syndrome coronavirus 2-positive polymerase chain reaction after week 6 was significantly associated with mortality (54.5% versus 1.4%; P < 0.001). We confirm an increased mortality compared with the general population. In view of our results, any interruption or delay in the start of treatment should be questioned given that active treatment has not been demonstrated to increase mortality risk and that achieving disease remission could lead to better outcomes.

Figure 1.

OS results of the entire cohort and based on admission, ICU admission and CURB-65 score. (A), Global OS. (B), OS comparing outpatients with inpatients. (C), OS for patients admitted in ICU vs no ICU. (D), OS categorized by CURB-65 score. CURB-65 = confusion, urea concentration, respiratory rate, blood pressure, and age >65; OS = overall survival.

Figure 2.

Overall survival results. Overall survival categorized by (A) histology subtype, (B) therapeutic regimen, (C) active treatment, and (D) active disease. AD = active disease; CR = complete response; DLBCL = diffuse large B cell lymphoma; FL = follicular lymphoma; OA = other agressive; OI = other indolent.