The direct and indirect effects of COVID-19 pandemic in a real-life hematological setting.
Adult
Aged
Aged, 80 and over
Antineoplastic Agents
/ therapeutic use
Antiviral Agents
/ therapeutic use
COVID-19
/ complications
Drug Therapy, Combination
Female
Hematologic Neoplasms
/ drug therapy
Humans
Male
Middle Aged
Prognosis
Retrospective Studies
SARS-CoV-2
/ isolation & purification
Spain
/ epidemiology
Survival Rate
Young Adult
COVID-19 Drug Treatment
COVID-19
SARS-CoV-2
hematology
leukemia
lymphoma
telemedicine
Journal
Cancer reports (Hoboken, N.J.)
ISSN: 2573-8348
Titre abrégé: Cancer Rep (Hoboken)
Pays: United States
ID NLM: 101747728
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
revised:
25
01
2021
received:
09
12
2020
accepted:
03
02
2021
pubmed:
4
3
2021
medline:
14
9
2021
entrez:
3
3
2021
Statut:
ppublish
Résumé
Clinical outcomes of novel coronavirus 2019 disease (COVID-19) in onco-hematological patients are unknown. When compared to non-immunocompromised patients, onco-hematological patients seem to have higher mortality rates. We describe the characteristics and outcomes of a consecutive cohort of 24 onco-hematological patients with COVID-19 during the first month of the pandemic. We also describe variations in healthcare resource utilization within our hematology department. Data from patients between the first month of the pandemic were retrospectively collected. Clinical and logistic data were also collected and compared with the average values from the prior 3 months of activity. Prevalence of COVID-19 in our hematological population was 0.4%. Baseline characteristics were as follows: male sex: 83%, lymphoid diseases: 46%, median age: 69 (22-82) years. Median follow-up in survivors was 14 (9-28) days and inpatient mortality rate was 46%. Average time to moderate/severe respiratory insufficiency and death were 3 (1-10) and 10 (3-18) days, respectively. Only 1 out of every 12 patients who developed moderate to severe respiratory insufficiency recovered. Upon univariate analysis, the following factors were associated with higher mortality: age ≥ 70 years (P = .01) and D-dimer ≥900 mcg/L (P = .04). With respect to indirect effects during the COVID-19 pandemic, and when compared with the prior 3 months of activity, inpatient mortality (excluding patients with COVID-19 included in the study) increased by 56%. This was associated with a more frequent use of vasoactive drugs (+300%) and advanced respiratory support (+133%) in the hematology ward. In the outpatient setting, there was a reduction in initial visits (-55%) and chemotherapy sessions (-19%). A significant increase in phone visits was reported (+581%). COVID-19 pandemic is associated with elevated mortality in hematological patients. Negative indirect effects are also evident within this setting.
Sections du résumé
BACKGROUND
Clinical outcomes of novel coronavirus 2019 disease (COVID-19) in onco-hematological patients are unknown. When compared to non-immunocompromised patients, onco-hematological patients seem to have higher mortality rates.
AIMS
We describe the characteristics and outcomes of a consecutive cohort of 24 onco-hematological patients with COVID-19 during the first month of the pandemic. We also describe variations in healthcare resource utilization within our hematology department.
METHODS AND RESULTS
Data from patients between the first month of the pandemic were retrospectively collected. Clinical and logistic data were also collected and compared with the average values from the prior 3 months of activity. Prevalence of COVID-19 in our hematological population was 0.4%. Baseline characteristics were as follows: male sex: 83%, lymphoid diseases: 46%, median age: 69 (22-82) years. Median follow-up in survivors was 14 (9-28) days and inpatient mortality rate was 46%. Average time to moderate/severe respiratory insufficiency and death were 3 (1-10) and 10 (3-18) days, respectively. Only 1 out of every 12 patients who developed moderate to severe respiratory insufficiency recovered. Upon univariate analysis, the following factors were associated with higher mortality: age ≥ 70 years (P = .01) and D-dimer ≥900 mcg/L (P = .04). With respect to indirect effects during the COVID-19 pandemic, and when compared with the prior 3 months of activity, inpatient mortality (excluding patients with COVID-19 included in the study) increased by 56%. This was associated with a more frequent use of vasoactive drugs (+300%) and advanced respiratory support (+133%) in the hematology ward. In the outpatient setting, there was a reduction in initial visits (-55%) and chemotherapy sessions (-19%). A significant increase in phone visits was reported (+581%).
CONCLUSION
COVID-19 pandemic is associated with elevated mortality in hematological patients. Negative indirect effects are also evident within this setting.
Identifiants
pubmed: 33656801
doi: 10.1002/cnr2.1358
pmc: PMC7994963
doi:
Substances chimiques
Antineoplastic Agents
0
Antiviral Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1358Informations de copyright
© 2021 The Authors. Cancer Reports published by Wiley Periodicals LLC.
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