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Review
. 2020;21(12):921-939.
doi: 10.1631/jzus.B2000423.

Weathering the storm: COVID-19 infection in patients with hematological malignancies

Lin-Qin Wang  1   2   3   4 , Elaine Tan Su Yin  1   2   3   4 , Guo-Qing Wei  1   2   3   4 , Yong-Xian Hu  1   2   3   4 , Arnon Nagler  5 , He Huang  1   2   3   4
Affiliations
Review

Weathering the storm: COVID-19 infection in patients with hematological malignancies

Lin-Qin Wang et al. J Zhejiang Univ Sci B. 2020.

Abstract

The coronavirus disease 2019 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Within a matter of months, this highly contagious novel virus has led to a global outbreak and is still spreading rapidly across continents. In patients with COVID-19, underlying chronic diseases and comorbidities are associated with dismal treatment outcomes. Owing to their immunosuppressive status, patients with hematological malignancies (HMs) are at an increased risk of infection and have a worse prognosis than patients without HMs. Accordingly, intensive attention should be paid to this cohort. In this review, we summarize and analyze specific clinical manifestations for patients with coexisting COVID-19 and HMs. Furthermore, we briefly describe customized management strategies and interventions for this susceptible cohort. This review is intended to guide clinical practice.

Keywords: Coronavirus disease 2019 (COVID-19); Hematological malignancies; Immunosuppressive status; Management strategies; Treatment regimen.

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Conflict of interest statement

Compliance with ethics guidelines: He HUANG, Arnon NAGLER, Yong-xian HU, Lin-qin WANG, Elaine TAN SU YIN, and Guo-qing WEI declare that they have no conflict of interest.

This article does not contain any studies with human or animal subjects performed by any of the authors.

Figures

Fig. 1
Fig. 1
Comparisons of chest imaging (X-ray and CT scans) of COVID-19 and CMV pneumonia These two types of pneumonia (COVID-19 vs. CMV) showed a somewhat similar progression in the initial stage, progressive stage, and consolidation stage/diffuse infiltration stage of infection. Initially, both presented with typical GGOs. (a) Chest imaging of COVID-19 pneumonia. A 51-year-old male was confirmed with COVID-19 and received CT scans on 4, 8, and 15 February, 2020. (b) Chest imaging of CMV pneumonia. A 26-year-old male with diffuse large B cell lymphoma (non-GCB, IVB stage) was diagnosed with CMV pneumonia during chemotherapy. He received CT scans on 4, 7, 22 March, 2020. COVID-19, coronavirus disease 2019; CMV, cytomegalovirus; CT, computed tomography; GCB, germinal center B-cell-like lymphoma; GGOs, ground-glass opacities
Fig. 2
Fig. 2
Flow diagram of hospital admission procedures for HM patients during the COVID-19 pandemic (a) Admission procedures in areas with a high prevalence of COVID-19; (b) Admission procedures in areas with a low prevalence of COVID-19. CAR-T, chimeric antigen receptor T cell; COVID-19, coronavirus disease 2019; CT, computed tomography; HM, hematological malignancy; HSCT, hematopoietic stem cell transplantation; MDT, multidisciplinary team; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
Fig. 3
Fig. 3
Overview of management strategies for HM patients during the COVID-19 pandemic ALSS, artificial liver support system; HM, hematological malignancy; COVID-19, coronavirus disease 2019; CT, computed tomography; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
See this image and copyright information in PMC

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