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. 2023 Dec:137:98-110.
doi: 10.1016/j.ijid.2023.10.013. Epub 2023 Oct 18.

Age, successive waves, immunization, and mortality in elderly COVID-19 hematological patients: EPICOVIDEHA findings

Giuseppe Rossi  1 , Jon Salmanton-García  2 , Chiara Cattaneo  1 , Francesco Marchesi  3 , Julio Dávila-Valls  4 , Sonia Martín-Pérez  4 , Federico Itri  5 , Alberto López-García  6 , Andreas Glenthøj  7 , Maria Gomes da Silva  8 , Caroline Besson  9 , Monia Marchetti  10 , Barbora Weinbergerová  11 , Ozren Jaksic  12 , Moraima Jiménez  13 , Yavuz M Bilgin  14 , Jaap Van Doesum  15 , Francesca Farina  16 , Pavel Žák  17 , Luisa Verga  18 , Graham P Collins  19 , Valentina Bonuomo  20 , Jens Van Praet  21 , Marcio Nucci  22 , Stef Meers  23 , Ildefonso Espigado  24 , Nicola S Fracchiolla  25 , Toni Valković  26 , Christian Bjørn Poulsen  27 , Natasha Čolović  28 , Giulia Dragonetti  29 , Marie-Pierre Ledoux  30 , Carlo Tascini  31 , Caterina Buquicchio  32 , Ola Blennow  33 , Francesco Passamonti  34 , Marina Machado  35 , Jorge Labrador  36 , Rafael F Duarte  37 , Martin Schönlein  38 , Lucia Prezioso  39 , Iker Falces-Romero  40 , Austin Kulasekararaj  41 , Carolina Garcia-Vidal  42 , Noemí Fernández  43 , Ghaith Abu-Zeinah  44 , Irati Ormazabal-Vélez  45 , Tatjana Adžić-Vukičević  46 , Klára Piukovics  47 , Igor Stoma  48 , Annarosa Cuccaro  49 , Gabriele Magliano  50 , Tomáš Szotkowski  51 , Tomás-José González-López  52 , Shaimaa El-Ashwah  53 , Rui Bergantim  54 , Uluhan Sili  55 , Johan Maertens  56 , Fatih Demirkan  57 , Cristina De Ramón  58 , Verena Petzer  59 , Maria Ilaria Del Principe  60 , Milan Navrátil  61 , Michelina Dargenio  62 , Guldane Cengiz Seval  63 , Michail Samarkos  64 , Zdeněk Ráčil  65 , László Imre Pinczés  66 , Tobias Lahmer  67 , Alessandro Busca  68 , Gustavo-Adolfo Méndez  69 , Antonio Vena  70 , Monika M Biernat  71 , Maria Merelli  31 , Maria Calbacho  72 , Aleksandra Barać  73 , Martina Bavastro  70 , Alessandro Limongelli  70 , Osman Ilhan  63 , Dominik Wolf  59 , Gökçe Melis Çolak  55 , Ramón García-Sanz  74 , Ziad Emarah  53 , Bojana Mišković  75 , Stefanie K Gräfe  76 , Miloš Mladenović  42 , Tommaso Francesco Aiello  42 , Lucía Núñez-Martín-Buitrago  37 , Anna Nordlander  33 , Elena Arellano  24 , Giovanni Paolo Maria Zambrotta  18 , Emanuele Ammatuna  15 , Alba Cabirta  77 , Maria Vittoria Sacchi  10 , Raquel Nunes Rodrigues  8 , Ditte Stampe Hersby  7 , Michaela Hanakova  65 , Laman Rahimli  78 , Raul Cordoba  6 , Oliver A Cornely  79 , Livio Pagano  80 ; Collaborators
Collaborators, Affiliations
Free article

Age, successive waves, immunization, and mortality in elderly COVID-19 hematological patients: EPICOVIDEHA findings

Giuseppe Rossi et al. Int J Infect Dis. 2023 Dec.
Free article

Abstract

Objectives: Elderly patients with hematologic malignancies face the highest risk of severe COVID-19 outcomes. The infection's impact on different age groups remains unstudied in detail.

Methods: We analyzed elderly patients (age groups: 65-70, 71-75, 76-80, and >80 years old) with hematologic malignancies included in the EPICOVIDEHA registry between January 2020 and July 2022. Univariable and multivariable Cox regression models were conducted to identify factors influencing death in COVID-19 patients with hematological malignancy.

Results: The study included data from 3,603 elderly patients (aged 65 or older) with hematological malignancy, with a majority being male (58.1%) and a significant proportion having comorbidities. The patients were divided into four age groups, and the analysis assessed COVID-19 outcomes, vaccination status, and other variables in relation to age and pandemic waves. The 90-day survival rate for patients with COVID-19 was 71.2%, with significant differences between groups. The pandemic waves had varying impacts, with the first wave affecting patients over 80 years old, the second being more severe in 65-70, and the third being the least severe in all age groups. Factors contributing to 90-day mortality included age, comorbidities, lymphopenia, active malignancy, acute leukemia, less than three vaccine doses, severe COVID-19, and using only corticosteroids as treatment.

Conclusion: These data underscore the heterogeneity of elderly hematological patients, highlight the different impacts of COVID-19 waves and the pivotal importance of vaccination, and may help in planning future healthcare efforts.

Keywords: COVID-19; Elderly; Hematological malignancy; High-risk patient; SARS-CoV-2.

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Conflict of interest statement

Declarations of competing interest The authors have no competing interests to declare.