COVID-19 severity and mortality in patients with CLL: an update of the international ERIC and Campus CLL study
Thomas Chatzikonstantinou(Centre for Research and Technology Hellas), Anargyros Kapetanakis(Centre for Research and Technology Hellas), Lydia Scarfò(Vita-Salute San Raffaele University), Georgios Karakatsoulis(University of Ioannina), David Allsup(Hull York Medical School), Alejandro Alonso Cabrero(Hospital Universitario de La Princesa), Martin Andres(University of Bern), Darko Antić(University of Belgrade), Mónica Baile(Instituto de Investigación Biomédica de Salamanca), Panagiotis Baliakas(Uppsala University), Dominique Bron(Institut Jules Bordet), Antonella Capasso(IRCCS Ospedale San Raffaele), Sofia Chatzileontiadou(AHEPA University Hospital), Raúl Córdoba(Hospital Universitario Fundación Jiménez Díaz), Juan Gonzalo Correa(Hospital Clínic de Barcelona), Carolina Cuéllar‐García(Hospital Terrassa), Lorenzo De Paoli(Università degli Studi del Piemonte Orientale “Amedeo Avogadro”), Maria Rosaria De Paolis(Ospedale Vito Fazzi), Giovanni Del Poeta(University of Rome Tor Vergata), Christos Demosthenous(G. Papanikolaou General Hospital), Maria Dimou(National and Kapodistrian University of Athens), D. Donaldson(University of Ulster), Michael Doubek(Masaryk University), Maria Efstathopoulou(Athens Medical Center), Barbara Eichhorst(University of Cologne), Shaimaa El‐Ashwah(Mansoura University), Alicia Enrico(Hospital Italiano La Plata), Blanca Espinet(Hospital Del Mar), Lucia Farina(Fondazione IRCCS Istituto Nazionale dei Tumori), Angela Ferrari(Azienda Sanitaria Unità Locale di Reggio Emilia), Myriam Foglietta(Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo), Henrik Frederiksen(Odense University Hospital), Moritz Fürstenau(University of Cologne), José A. García‐Marco(Hospital Universitario Puerta de Hierro Majadahonda), Rocío García‐Serra(Hospital General Universitario De Valencia), Massimo Gentile(Azienda Ospedaliera di Cosenza), Eva Gimeno(Hospital Del Mar), Andreas Glenthøj(Copenhagen University Hospital), María Gomes da Silva(Instituto Português de Oncologia Francisco Gentil), Odit Gutwein(Tel Aviv University), Yervand Hakobyan, Yair Herishanu(Tel Aviv University), José‐Ángel Hernández‐Rivas(Hospital Universitario Infanta Leonor), Tobias Herold(LMU Klinikum), Idanna Innocenti(Agostino Gemelli University Polyclinic), Gilad Itchaki(Tel Aviv University), Ozren Jakšić(University Hospital Dubrava), Ann Janssens(Universitair Ziekenhuis Leuven), Olga Kalashnikova(First Pavlov State Medical University of St. Petersburg), Elżbieta Kalicińska(Wroclaw Medical University), Linda Karlsson(Copenhagen University Hospital), Arnon P. Kater(Amsterdam University Medical Centers), Sabina Kersting(Haga Hospital), Jorge Labrador(Hospital Universitario de Burgos), Deepesh Lad(Post Graduate Institute of Medical Education and Research), Luca Laurenti(Università Cattolica del Sacro Cuore), Mark‐David Levin(Albert Schweitzer Ziekenhuis), Enrico Lista(Ospedale Santa Chiara), Alberto López‐García(Hospital Universitario Fundación Jiménez Díaz), Lara Malerba(Ospedali Riuniti Marche Nord), Roberto Marasca(University of Modena and Reggio Emilia), Monia Marchetti(Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo), Juan Marquet(Instituto Cajal), Mattias Mattsson(Uppsala University), Francesca Romana Mauro(Sapienza University of Rome), Ivana Milošević(University of Novi Sad), Fátima Mirás(Hospital Universitario 12 De Octubre), Marta Morawska(Medical University of Lublin), Marina Motta(Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia), Talha Munir(St James's University Hospital), Roberta Murru(Azienda Ospedaliera G. Brotzu), Carsten Utoft Niemann(Copenhagen University Hospital), Raquel Nunes Rodrigues(Instituto Português de Oncologia Francisco Gentil), Jacopo Olivieri(Ospedale Santa Maria della Misericordia di Udine), Lorella Orsucci(Azienda Ospedaliera Citta' della Salute e della Scienza di Torino), Maria Papaioannou(AHEPA University Hospital), Miguel Arturo Pavlovsky, Inga Piskunova(National Medical Research Center for Hematology), Viola Maria Popov(Spitalul Clinic Colentina), Francesca Maria Quaglia(University of Verona), Giulia Quaresmini(Ospedale Papa Giovanni XXIII), Kristian Qvist(Regional Hospital West Jutland), Gianluigi Reda(Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico), Gian Matteo Rigolin, Rosa Ruchlemer(Shaare Zedek Medical Center), Gevorg Saghumyan, Amit Shrestha(Nepal Cancer Hospital and Research Center), Martin Šimkovič(Charles University), Martin Špaček(Charles University), Paolo Sportoletti(University of Perugia), Oana Stanca(Carol Davila University of Medicine and Pharmacy), Niki Stavroyianni(G. Papanikolaou General Hospital), Tamar Tadmor(Bnai Zion Medical Center), Doreen te Raa(Ziekenhuis Gelderse Vallei), Sanne H. Tonino(Amsterdam University Medical Centers), Livio Trentin(University of Padua), Ellen van der Spek(Rijnstate Hospital), Michel van Gelder(Maastricht University), Roel van Kampen(Zuyderland Medisch Centrum), Marzia Varettoni(Policlinico San Matteo Fondazione), Andrea Visentin(University of Padua), Candida Vitale(University of Turin), Ewa Wąsik‐Szczepanek(Medical University of Lublin), Tomasz Wróbel(Wroclaw Medical University), Lucrecia Yáñez(Instituto de Investigación Marqués de Valdecilla), Mohamed A. Yassin(National Center for Cancer Care and Research), Marta Coscia(University of Turin), Alessandro Rambaldi(University of Milan), Emili Montserrat(Hospital Clínic de Barcelona), Robin Foà(Sapienza University of Rome), Antonio Cuneo, Κώστας Σταματόπουλος(Centre for Research and Technology Hellas), Paolo Ghia(Vita-Salute San Raffaele University)
Cited by 94Open Access
Abstract
Patients with chronic lymphocytic leukemia (CLL) may be more susceptible to Coronavirus disease 2019 (COVID-19) due to age, disease, and treatment-related immunosuppression. We aimed to assess risk factors of outcome and elucidate the impact of CLL-directed treatments on the course of COVID-19. We conducted a retrospective, international study, collectively including 941 patients with CLL and confirmed COVID-19. Data from the beginning of the pandemic until March 16, 2021, were collected from 91 centers. The risk factors of case fatality rate (CFR), disease severity, and overall survival (OS) were investigated. OS analysis was restricted to patients with severe COVID-19 (definition: hospitalization with need of oxygen or admission into an intensive care unit). CFR in patients with severe COVID-19 was 38.4%. OS was inferior for patients in all treatment categories compared to untreated (p < 0.001). Untreated patients had a lower risk of death (HR = 0.54, 95% CI:0.41-0.72). The risk of death was higher for older patients and those suffering from cardiac failure (HR = 1.03, 95% CI:1.02-1.04; HR = 1.79, 95% CI:1.04-3.07, respectively). Age, CLL-directed treatment, and cardiac failure were significant risk factors of OS. Untreated patients had a better chance of survival than those on treatment or recently treated.
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