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. 2024 Apr 9;5(3):505-515.
doi: 10.1002/jha2.867. eCollection 2024 Jun.

Severe acute respiratory syndrome coronavirus 2 infection in patients with hematological malignancies in the Omicron era: Respiratory failure, need for mechanical ventilation and mortality in seronegative and seropositive patients

Erica Franceschini  1 , Valentina Menozzi  1 , Vera Todisco  1 , Mariachiara Pellegrino  1 , Samuele Cantergiani  1 , Andrea Dessilani  1 , Anna Spadoni  1 , Federico Romani  1 , Alice Mazzocchi  1 , Antonella Santoro  1 , Marianna Meschiari  1 , Adriana Cervo  1 , Andrea Gilioli  2 , Francesca Bettelli  1 , Giulia Fregni-Serpini  3 , Antonella Grottola  3 , Anna Candoni  2 , Giovanni Guaraldi  1 , Mario Sarti  4 , Mario Luppi  1 , Cristina Mussini  1
Affiliations

Severe acute respiratory syndrome coronavirus 2 infection in patients with hematological malignancies in the Omicron era: Respiratory failure, need for mechanical ventilation and mortality in seronegative and seropositive patients

Erica Franceschini et al. EJHaem. .

Abstract

Background: Patients with hematological malignancies (HM) have a high risk of severe coronavirus disease 2019 (COVID-19), also in the Omicron period.

Material and methods: Retrospective single-center study including HM patients with severe acute respiratory syndrome Coronavirus 2 (SARS-CoV2) infection from January 2022 to March 2023. Study outcomes were respiratory failure (RF), mechanical ventilation (MV), and COVID-related mortality, comparing patients according to SARS-CoV2 serology.

Results: Note that, 112 patients were included: 39% had negative SARS-CoV2 serology. Seronegative were older (71.5 vs. 65.0 years, p = 0.04), had more often a lymphoid neoplasm (88.6% vs. 69.1%, p = 0.02), underwent anti-CD20 therapy (50.0% vs. 30.9% p = 0.04) and had more frequently a severe disease (23.0% vs. 3.0%, p = 0.02) than seropositive.Kaplan-Meier showed a higher risk for seronegative patients for RF (p = 0.014), MV (p = 0.044), and COVID-related mortality (p = 0.021). Negative SARS-CoV2 serostatus resulted in a risk factor for RF (hazards ratio [HR] 2.19, 95% confidence interval [CI] 1.03-4.67, p = 0.04), MV (HR 3.37, 95% CI 1.06-10.68, p = 0.04), and COVID-related mortality (HR 4.26, 95% CI 1.09-16.71, p = 0.04).

Conclusions: : HM patients with negative SARS-CoV2 serology, despite vaccinations and previous infections, have worse clinical outcomes compared to seropositive patients in the Omicron era. The use of serology for SARS-CoV2 diagnosis could be an easy tool to identify patients prone to developing complications.

Keywords: COVID‐19; hematological malignancies; serostatus.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Study flowchart.
FIGURE 2
FIGURE 2
Kaplan‐Meier for respiratory failure (A), mechanical ventilation (B), and coronavirus disease (COVID)‐related mortality (C) by serostatus group.
See this image and copyright information in PMC

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