COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA)

Livio Pagano(Università Cattolica del Sacro Cuore), Jon Salmanton‐García(University of Cologne), Francesco Marchesi(Istituti di Ricovero e Cura a Carattere Scientifico), Alessandro Busca(Azienda Ospedaliera Citta' della Salute e della Scienza di Torino), Paolo Corradini(University of Milan), Martin Hoenigl(Medical University of Graz), Н Н Климко(North-Western State Medical University named after I.I. Mechnikov), Philipp Koehler(University of Cologne), Antonio Pagliuca(King's College Hospital NHS Foundation Trust), Francesco Passamonti(University of Insubria), Luisa Verga(Azienda Ospedaliera San Gerardo), Benjamín Víšek(University Hospital Hradec Králové), Osman İlhan(Ankara University), Gianpaolo Nadali(University of Verona), Barbora Weinbergerová(Masaryk University), Raúl Córdoba(Hospital Universitario Fundación Jiménez Díaz), Monia Marchetti(Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo), Graham P. Collins(Churchill Hospital), Francesca Farina(Vita-Salute San Raffaele University), Chiara Cattaneo(Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia), Alba Cabirta(Universitat Autònoma de Barcelona), María Gomes da Silva(Instituto Português de Oncologia Francisco Gentil), Federico Itri(Ospedale San Luigi Gonzaga), Jaap A. van Doesum(University Medical Center Groningen), Marie‐Pierre Ledoux(Institut de Cancérologie Strasbourg), Martin Čerňan(University Hospital Olomouc), Ozren Jakšić(University Hospital Dubrava), Rafael F. Duarte(Hospital Universitario Puerta de Hierro Majadahonda), Gabriele Magliano(Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda), Ali S. Omrani(Hamad Medical Corporation), Nicola Fracchiolla(Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico), Austin Kulasekararaj(King's College London), Toni Valković(Croatian Chamber of Economy), Christian Bjørn Poulsen(Zealand University Hospital), Marina Machado(Hospital General Universitario Gregorio Marañón), Andreas Glenthøj(Rigshospitalet), И. О. Стома(Gomel State Medical University), Zdeněk Ráčil(Institute of Haematology and Blood Transfusion), Klára Piukovics(University of Szeged), Milan Navrátil(University Hospital Ostrava), Ziad Emarah(Mansoura University), Uluhan Sili(Marmara University), Johan Maertens(KU Leuven), Ola Blennow(Karolinska University Hospital), Rui Bergantim(Universidade do Porto), Carolina García‐Vidal(Hospital Clínic de Barcelona), Lucia Prezioso(Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico), Anna Guidetti(Fondazione IRCCS Istituto Nazionale dei Tumori), Maria Ilaria Del Principe(University of Rome Tor Vergata), Marina Popova(First Pavlov State Medical University of St. Petersburg), Nick de Jonge(Amsterdam University Medical Centers), Irati Ormazabal‐Vélez(Complejo Hospitalario de Navarra), Noemí Fernández(Marqués de Valdecilla University Hospital), Iker Falces‐Romero(Hospital Universitario La Paz), Annarosa Cuccaro(Azienda Usl Toscana Centro), Stef Meers(AZ Klina), Caterina Buquicchio, Darko Antić(University of Belgrade), Murtadha Al‐Khabori(Sultan Qaboos University Hospital), Ramón García‐Sánz(Complejo Hospitalario de Salamanca), Monika Biernat(Wroclaw Medical University), Maria Chiara Tisi(Ospedale San Bortolo), Ertan Sal(University of Cologne), Laman Rahimli(University of Cologne), Nataša Čolović(University of Belgrade), Martin Schönlein(Universität Hamburg), María Calbacho(Hospital Universitario 12 De Octubre), Carlo Tascini, Carolina Miranda(Hospital Universitario Rey Juan Carlos), Nina Khanna(University Hospital of Basel), Gustavo‐Adolfo Méndez, Verena Petzer(Innsbruck Medical University), Jan Novák(University Hospital Kralovske Vinohrady), Caroline Besson(Centre Hospitalier de Versailles), Rémy Duléry(Inserm), Sylvain Lamure(Centre National de la Recherche Scientifique), Márcio Nucci(Universidade Federal do Rio de Janeiro), Giovanni Paolo Maria Zambrotta(Azienda Ospedaliera San Gerardo), Павел Зак(University Hospital Hradec Králové), Güldane Cengiz Seval(Ankara University), Valentina Bonuomo(University of Verona), Jiřı́ Mayer(Masaryk University), Alberto López‐García(Hospital Universitario Fundación Jiménez Díaz), Maria Vittoria Sacchi(Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo), Stephen Booth(Churchill Hospital), Fabio Ciceri(Vita-Salute San Raffaele University), Margherita Oberti(Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia), Marco Salvini(University of Insubria), Macarena Izuzquiza(Universitat Autònoma de Barcelona), Raquel Nunes Rodrigues(Instituto Português de Oncologia Francisco Gentil), Emanuele Ammatuna(University Medical Center Groningen), Aleš Obr(University Hospital Olomouc), Raoul Herbrecht(Institut de Cancérologie Strasbourg), Lucía Núñez-Martín-Buitrago(Hospital Universitario Puerta de Hierro Majadahonda), Valentina Mancini(Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda), Hawraa Shwaylia(National Center for Cancer Care and Research), Mariarita Sciumé(Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico), Jenna Essame(King's College Hospital), Marietta Nygaard(Zealand University Hospital), Josip Batinić(Croatian Chamber of Economy), Yung Gonzaga(Instituto Nacional de Câncer - INCA), Isabel Regalado‐Artamendi(Hospital General Universitario Gregorio Marañón), Linda Karlsson(Rigshospitalet), Maryia Shapetska(Republican Scientific and Practical Center of Neurology and Neurosurgery), Michaela Hanáková(Institute of Haematology and Blood Transfusion), Shaimaa El‐Ashwah(Mansoura University), Zita Borbényi(University of Szeged), Gökçe Melis Çolak(Marmara University), Anna Nordlander(Karolinska University Hospital), Giulia Dragonetti(Università Cattolica del Sacro Cuore), Alessio Maria Edoardo Maraglino(Università Cattolica del Sacro Cuore), A. Rinaldi(Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico), Cristina De Ramón(Instituto de Investigación Biomédica de Salamanca), Oliver A. Cornely(University of Cologne), EPICOVIDEHA working group, Olimpia Finizio(Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico), Rita Fazzi, Giuseppe Sapienza, Adrien Chauchet, Jens Van Praet, Juergen Prattes, Michelina Dargenio, Cédric Rossi, Ayten Shirinova, Sandra Malak, Agostino Tafuri, Hans Beier Ommen, Serge Bologna, Reham Khedr(Centre National de la Recherche Scientifique), Sylvain Choquet, Bertrand Joly, M. Mansour Ceesay, Laure Philippe, Chi Shan Kho, Maximilian Desole, Panagiotis Tsirigotis, Vladimir Otašević, Davimar Miranda Maciel Borducchi, Anastasia Antoniadou, Javid Gaziev, Muna Almaslamani, Nicole García‐Poutón, Giovangiacinto Paterno(Rigshospitalet), Andrea Torres-López, Giuseppe Tarantini, Sibylle C. Mellinghoff, Stefanie K. Gräfe, Niklas Börschel, Jakob Passweg(Hospital Universitario 12 De Octubre), Maria Merelli, Aleksandra Barać, Dominik Wolf‎, Mohammad Usman Shaikh, Catherine Thiéblemont, Sophie Bernard, Vaneuza Araújo Moreira Funke, Étienne Daguindau, С. Н. Хостелиди(Universidade Federal do Rio de Janeiro), Fabio Moore Nucci, Juan-Alberto Martín-González, Marianne Landau, Carole Soussain, Cécile Laureana, Karine Lacombe, Milena Kohn, Gunay Aliyeva, Monica Piedimonte, Guillemette Fouquet, Mayara Rêgo, Baerbel Hoell-Neugebauer, Guillaume Cartron, Fernando Campos Gomes Pinto, Ana M. Munhoz Alburquerque, Juliana Portela Passos, Asu Fergün Yılmaz, Ana-Margarita Redondo-Izal, Fevzi Altuntaş, Christopher H. Heath(Universität Hamburg), Martin Kolditz, Enrico Schalk(Vita-Salute San Raffaele University), Fabio Guolo, Meinolf Karthaus, Roberta Della Pepa, Donald C. Vinh(Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico), Nicolas Noël, Bénédicte Deau, Bernard Drénou, Maria Enza Mitra, Joseph Meletiadis, Yavuz M. Bilgin(University Hospital Hradec Králové), Pavel Jindra, Ildefonso Espigado, Ľuboš Drgoňa, Alexandra Serris, Roberta Di Blasi(Hamad Medical Corporation), Natasha Ali
Journal of Hematology & Oncology
October 14, 2021
10.1186/s13045-021-01177-0
Cited by 316Open Access
Full Text

Abstract

BACKGROUND: Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality. METHODS: The survey was supported by the Scientific Working Group Infection in Hematology of the European Hematology Association (EHA). Eligible for the analysis were adult patients with HM and laboratory-confirmed COVID-19 observed between March and December 2020. RESULTS: The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma n = 1084, myeloma n = 684 and chronic lymphoid leukemia n = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia n = 497 and myelodysplastic syndromes n = 279). Severe/critical COVID-19 was observed in 63.8% of patients (n = 2425). Overall, 2778 (73.1%) of the patients were hospitalized, 689 (18.1%) of whom were admitted to intensive care units (ICUs). Overall, 1185 patients (31.2%) died. The primary cause of death was COVID-19 in 688 patients (58.1%), HM in 173 patients (14.6%), and a combination of both COVID-19 and progressing HM in 155 patients (13.1%). Highest mortality was observed in acute myeloid leukemia (199/497, 40%) and myelodysplastic syndromes (118/279, 42.3%). The mortality rate significantly decreased between the first COVID-19 wave (March-May 2020) and the second wave (October-December 2020) (581/1427, 40.7% vs. 439/1773, 24.8%, p value < 0.0001). In the multivariable analysis, age, active malignancy, chronic cardiac disease, liver disease, renal impairment, smoking history, and ICU stay correlated with mortality. Acute myeloid leukemia was a higher mortality risk than lymphoproliferative diseases. CONCLUSIONS: This survey confirms that COVID-19 patients with HM are at high risk of lethal complications. However, improved COVID-19 prevention has reduced mortality despite an increase in the number of reported cases.

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