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. 2021 Oct;32(10):1297-1300.
doi: 10.1016/j.annonc.2021.07.002. Epub 2021 Jul 13.

Severe COVID-19 in patients with hematological cancers presenting with viremia

J M Michot  1 , T Hueso  2 , N Ibrahimi  3 , F Pommeret  4 , C Willekens  2 , E Colomba  4 , S Francis  5 , A Bayle  4 , P H Cournède  6 , M Merad  7 , S Foulon  3 , L Albiges  4 , B Gachot  7 , F Barlesi  8 , J C Soria  9 , V Ribrag  2 , F Griscelli  5
Affiliations

Severe COVID-19 in patients with hematological cancers presenting with viremia

J M Michot et al. Ann Oncol. 2021 Oct.
No abstract available

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Conflict of interest statement

Disclosure JMM reports outside of the submitted work, sponsorship for research at the Gustave Roussy Cancer Centre from AbbVie, Agios, Amgen, Astex, AstraZeneca, Bayer, BeiGene, Blueprint Medicines, Bristol Myers Squibb, Boehringer Ingelheim, Celgene, Chugai, Forma, Genentech, GlaxoSmithKline, H3 Biomedicine, Incyte, Innate Pharma, Janssen, Lilly, Loxo, MedImmune, MSD, Novartis, Oncopeptides, Roche, Sanofi, Taiho and Xencor as well as personal fees, travel grants or advisory board fees from Astex, iQone, Mundipharma and Bristol Myers Squibb. LA reports outside of the submitted work, receiving consulting fees from Pfizer, Novartis, Bristol Myers Squibb, Ipsen, Roche, MSD, AstraZeneca, Merck, Amgen, Astellas, Exelixis, Corvus Pharmaceuticals and Peloton Therapeutics. FB reports outside of the submitted work, receiving personal fees from AstraZeneca, Bayer, Bristol Myers Squibb, Boehringer Ingelheim, Eli Lilly Oncology, F. Hoffmann-La Roche, Novartis, Merck, MSD, Pierre Fabre, Pfizer, and Takeda. VR reports outside of the submitted work, receiving sponsorship for research at the Gustave Roussy Cancer Centre from AbbVie, Agios, Amgen, Astex, AstraZeneca, Bayer, BeiGene, Blueprint Medicines, Bristol Myers Squibb, Boehringer Ingelheim, Celgene, Chugai, Forma, Genentech, GlaxoSmithKline, H3 Biomedicine, Incyte, Innate Pharma, Janssen, Lilly, Loxo, MedImmune, MSD, Novartis, Oncopeptides, Roche, Sanofi, Taiho and Xencor as well as personal fees, travel grants or advisory board fees from Astex, iQone, Mundipharma and Bristol Myers Squibb. All other authors have declared no conflicts of interest.

Figures

Figure 1
Figure 1
Main laboratory parameters in patients hospitalized for coronavirus disease (COVID-19) and having hematological cancers. (A) Correlation matrix between the quantitative variables observed in patients included in the study. The correlation matrix computed 14 numeric variables using the statistical Pearson method (∗P value for interaction <0.05). A positive correlation between two variables was illustrated by a blue color, whereas a negative correlation was in red. A thin ellipse meant that the relationship between the two variables was linear. The severity of COVID-19 evaluated by World Health Organization (WHO) score, as emphasized by the black rectangle, top correlated negatively with γ-globulins (r = −0.43; P = 0.0018), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RT-PCR nasopharyngeal swabs at day 1 of hospitalization cycle threshold (Ct) (r = −0.30, P = 0.0482) and absolute lymphocyte count (r = −0.21, P = 0.1428). The severity of COVID-19 evaluated by WHO score top correlated positively with lactate dehydrogenase (LDH) (r = +0.37, P = 0.0073), age (r = +0.34, P = 0.0154), duration of positive nasopharyngeal viral carriage assessed by SARS-CoV-2 RT-PCR (r = +0.28; P = 0.0540) and serum procalcitonin (r = +0.28; P = 0.0550). (B) This figure indicates the kinetics of Ct in nasopharyngeal SARS-CoV-2 RT-PCR, in patients with hematological cancers and hospitalized for COVID-19, according to the serum level of γ-globulins (with a threshold of 6 g/l for γ-globulin levels) (n = 49 patients evaluated for γ-globulin levels). All positive nasopharyngeal swabs detected by PCR in the patients included in the study are indicated. Each point represents one nasopharyngeal swab carried out by PCR. The number of Ct SARS-CoV-2 RT-PCR points analyzed were 86 points in patients with γ-globulin levels <6 g/l and 56 points in patients with γ-globulin levels ≥6 g/l. Colored lines represent polynomial trend lines, by second order polynomial, for patients with γ-globulin levels <6 g/l (red line) and ≥6 g/l (blue line). To compare all Ct SARS-CoV-2 RT-PCR values in patients with γ-globulin levels <6 g/l and ≥6 g/l, XY analyses were carried out with nonlinear regression. The comparison method was extra sum-of-squares F test and the P value was 0.05. The curves representing SARS-CoV-2 RT-PCR for each data set were different with P value = 0.0033. The red curve above the blue curve shows that patients with hypogammaglobulinemia in their serum have more intense and prolonged SARS-CoV-2 nasopharyngeal virus replication assessed by SARS-CoV-2 RT-PCR of nasopharyngeal swabs. (C) SARS-CoV-2 viremia in patients with hematological cancers. This figure shows the clinical and biological parameters associated with viremia in patients with hematological cancers. Viremia was detected by SARS-CoV-2 RT-PCR on blood (as indicated in the methods appendix) at day 1 of hospitalization. Overall, 21 patients were investigated for viremia, 10 were positive and 11 were negative. For each factor, the median value calculated over the entire population (N = 51 patients) was used to determine the cut-off for each variable in subgroups. The relative risk and its 95% confidence interval (CI) as well as the P value for the interaction, calculated by Fisher's exact test, are shown for each parameter in the table. Gray bars in the figure indicate 95% CI. ANC, absolute neutrophil count; BMI, body mass index; COVID-19, coronavirus disease 2019; CRP, C-reactive protein; LDH, lactate dehydrogenase; NA, not available; naso., nasopharyngeal; RT-PCR, reverse-transcriptase PCR; SARS-CoV-2, severe acute respiratory syndrome coronavirus; WHO, World Health Organization.
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