Risk factors and outcomes of COVID-19 in adult patients with hematological malignancies: A single-center study showing lower than expected rates of hospitalization and mortality.
COVID-19
anti-CD20 antibodies
hematological malignancies
hematological neoplasms
monoclonal antibodies
Journal
European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985
Informations de publication
Date de publication:
Jul 2023
Jul 2023
Historique:
revised:
11
03
2023
received:
07
01
2023
accepted:
16
03
2023
medline:
9
6
2023
pubmed:
25
4
2023
entrez:
25
04
2023
Statut:
ppublish
Résumé
Studies addressing coronavirus disease 2019 (COVID-19) in patients with hematological malignancies have reported mortality rates of up to 40%; however, included predominantly hospitalized patients. During the first year of the pandemic, we followed adult patients with hematological malignancies treated at a tertiary center in Jerusalem, Israel, who contracted COVID-19, with the aim of studying risk factors for adverse COVID-19-related outcomes. We used remote communication to track patients managed at home-isolation, and patient questioning to assess the source of COVID-19 infection, community versus nosocomial. Our series included 183 patients, median age was 62.5 years, 72% had at least one comorbidity and 39% were receiving active antineoplastic treatment. Hospitalization, critical COVID-19, and mortality rates were 32%, 12.6%, and 9.8%, respectively, remarkably lower than previously reported. Age, multiple comorbidities, and active antineoplastic treatment were significantly associated with hospitalization due to COVID-19. Treatment with monoclonal antibodies was strongly associated with both hospitalization and critical COVID-19. In older (≥60) patients not receiving active antineoplastic treatment, mortality, and severe COVID-19 rates were comparable to those of the general Israeli population. We did not detect patients that contracted COVID-19 within the Hematology Division. These findings are relevant for the future management of patients with hematological malignancies in COVID-19-affected regions.
Sections du résumé
BACKGROUND
BACKGROUND
Studies addressing coronavirus disease 2019 (COVID-19) in patients with hematological malignancies have reported mortality rates of up to 40%; however, included predominantly hospitalized patients.
METHODS
METHODS
During the first year of the pandemic, we followed adult patients with hematological malignancies treated at a tertiary center in Jerusalem, Israel, who contracted COVID-19, with the aim of studying risk factors for adverse COVID-19-related outcomes. We used remote communication to track patients managed at home-isolation, and patient questioning to assess the source of COVID-19 infection, community versus nosocomial.
RESULTS
RESULTS
Our series included 183 patients, median age was 62.5 years, 72% had at least one comorbidity and 39% were receiving active antineoplastic treatment. Hospitalization, critical COVID-19, and mortality rates were 32%, 12.6%, and 9.8%, respectively, remarkably lower than previously reported. Age, multiple comorbidities, and active antineoplastic treatment were significantly associated with hospitalization due to COVID-19. Treatment with monoclonal antibodies was strongly associated with both hospitalization and critical COVID-19. In older (≥60) patients not receiving active antineoplastic treatment, mortality, and severe COVID-19 rates were comparable to those of the general Israeli population. We did not detect patients that contracted COVID-19 within the Hematology Division.
CONCLUSION
CONCLUSIONS
These findings are relevant for the future management of patients with hematological malignancies in COVID-19-affected regions.
Substances chimiques
Antineoplastic Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
135-145Informations de copyright
© 2023 The Authors. European Journal of Haematology published by John Wiley & Sons Ltd.
Références
Raynaud M, Zhang H, Louis K, et al. COVID-19-related medical research: a meta-research and critical appraisal. BMC Med Res Methodol. 2021;21(1):1.
Liang W, Guan W, Chen R, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3):335-337.
Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-1242.
Robilotti EV, Babady NE, Mead PA, et al. Determinants of COVID-19 disease severity in patients with cancer. Nat Med. 2020;26(8):1218-1223.
Goyal P, Choi JJ, Pinheiro LC, et al. Clinical characteristics of Covid-19 in New York City. N Engl J Med. 2020;382(24):2372-2374.
Wood WA, Neuberg DS, Thompson JC, et al. Outcomes of patients with hematologic malignancies and COVID-19: a report from the ASH research collaborative data hub. Blood Adv. 2020;4(23):5966-5975.
García-Suárez J, de la Cruz J, Cedillo Á, et al. Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study. J Hematol Oncol. 2020;13(1):133.
Piñana JL, Martino R, García-García I, et al. Risk factors and outcome of COVID-19 in patients with hematological malignancies. Exp Hematol Oncol. 2020;9:21.
Passamonti F, Cattaneo C, Arcaini L, et al. Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study. Lancet Haematol. 2020;7(10):e737-e745.
Levy I, Lavi A, Zimran E, et al. COVID-19 among patients with hematological malignancies: a national Israeli retrospective analysis with special emphasis on treatment and outcome. Leuk Lymphoma. 2021;62(14):3384-3393.
Vijenthira A, Gong IY, Fox TA, et al. Outcomes of patients with hematologic malignancies and COVID-19: a systematic review and meta-analysis of 3377 patients. Blood. 2020;136(25):2881-2892.
Pagano L, Salmanton-García J, Marchesi F, et al. COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association survey (EPICOVIDEHA). J Hematol Oncol. 2021;14(1):168.
Lee LYW, Cazier JB, Starkey T, et al. COVID-19 prevalence and mortality in patients with cancer and the effect of primary tumour subtype and patient demographics: a prospective cohort study. Lancet Oncol. 2020;21(10):1309-1316.
Sharafeldin N, Bates B, Song Q, et al. Outcomes of COVID-19 in patients with cancer: report from the national COVID cohort collaborative (N3C). J Clin Oncol. 2021;39(20):2232-2246.
Yu J, Ouyang W, Chua MLK, Xie C. SARS-CoV-2 transmission in patients with cancer at a tertiary Care Hospital in Wuhan. China JAMA Oncol. 2020;6(7):1108-1110.
Zeidan AM, Boddu PC, Patnaik MM, et al. Special considerations in the management of adult patients with acute leukaemias and myeloid neoplasms in the COVID-19 era: recommendations from a panel of international experts. Lancet Haematol. 2020;7(8):e601-e612.
Yahalom J, Dabaja BS, Ricardi U, et al. ILROG emergency guidelines for radiation therapy of hematological malignancies during the COVID-19 pandemic. Blood. 2020;135(21):1829-1832.
Infante MS, González-Gascón Y, Marín I, et al. COVID-19 in patients with hematological malignancies: a retrospective case series. Int J Lab Hematol. 2020;42(6):e256-e259.
Malard F, Genthon A, Brissot E, et al. COVID-19 outcomes in patients with hematologic disease. Bone Marrow Transplant. 2020;55(11):2180-2184.
Pagano L, Salmanton-García J, Marchesi F, et al. COVID-19 in vaccinated adult patients with hematological malignancies: preliminary results from EPICOVIDEHA. Blood. 2022;139(10):1588-1592.
Mittelman M, Magen O, Barda N, et al. Effectiveness of the BNT162b2mRNA COVID-19 vaccine in patients with hematological neoplasms in a nationwide mass vaccination setting. Blood. 2022;139(10):1439-1451.
Chowdhury O, Bruguier H, Mallett G, et al. Impaired antibody response to COVID-19 vaccination in patients with chronic myeloid neoplasms. Br J Haematol. 2021;194(6):1010-1015.
Moor MB, Suter-Riniker F, Horn MP, et al. Humoral and cellular responses to mRNA vaccines against SARS-CoV-2 in patients with a history of CD20 B-cell-depleting therapy (RituxiVac): an investigator-initiated, single-Centre, open-label study. Lancet Rheumatol. 2021;3(11):e789-e797.
Langerbeins P, Hallek M. COVID-19 in patients with hematologic malignancy. Blood. 2022;140(3):236-252.
Wang Q, Iketani S, Li Z, et al. Alarming antibody evasion properties of rising SARS-CoV-2 BQ and XBB subvariants. Cell. 2022;S0092867422015318.
Markov PV, Katzourakis A, Stilianakis NI. Antigenic evolution will lead to new SARS-CoV-2 variants with unpredictable severity. Nat Rev Microbiol. 2022;20(5):251-252.
COVID-19 Data Tracker, Israel Ministry of Health website [Internet]. 2022. Accessed December 28, 2022. https://datadashboard.health.gov.il/COVID-19/general.
Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected, World Health Organization (WHO) website [Internet]. 2022. Accessed December 28, 2022. https://www.who.int/publications-detail-redirect/10665-332299.
Berlin DA, Gulick RM, Martinez FJ. Severe Covid-19. N Engl J Med. 2020 Dec 17;383(25):2451-2460.
Clinical spectrum of SARS-CoV-2 infection, National Institute of Health (NIH) COVID-19 treatment guidelines. NIH website. 2023. Accessed February 26, 2023. https://www.covid19treatmentguidelines.nih.gov/overview/clinical-spectrum/.
COVID Live - Coronavirus Statistics - Worldometer [Internet]. 2022. Accessed December 28, 2022. https://www.worldometers.info/coronavirus/.
Fattore GL, Olivos NSA, Olalla JEC, Gomez L, Marucco AF, Mena MPR. Mortality in patients with cancer and SARS-CoV-2 infection: results from the Argentinean network of hospital-based cancer registries. Cancer Epidemiol. 2022;79:102200.
Goudsmit A, Cubilier E, Meert AP, et al. Factors associated with SARS-CoV-2 infection and outcome in patients with solid tumors or hematological malignancies: a single-center study. Support Care Cancer. 2021;29(11):6271-6278.
Chien KS, Peterson C, Young E, et al. Outcomes of breakthrough COVID-19 infections in patients with hematologic malignancies. Blood Adv. 2023;bloodadvances.2022008827.
Duléry R, Lamure S, Delord M, et al. Prolonged in-hospital stay and higher mortality after Covid-19 among patients with non-Hodgkin lymphoma treated with B-cell depleting immunotherapy. Am J Hematol. 2021;96(8):934-944.
Ip A, Mato A, Intrator J, et al. COVID-19 impact on lymphoma Patients' clinical outcomes - an observational cohort study. Blood. 2020;136(Supplement 1):6-7.
García-Sancho AM, Izuzquiza M, Bastos-Oreiro M, et al. Outcomes of patients with lymphoma and COVID-19: An Observational Cohort Study From Geltamo Spanish Group. Hematol Oncol. 2021;39(S2):hon.200_2880.
Yue X, Hallett D, Liu Y, Iyengar R, Basa E, Yang H. Characteristics and outcomes of COVID-19 patients with mature B-cell non-Hodgkin lymphomas (mB-cell NHL): a US Nationwide electronic health record (EHR) database study. Blood. 2021;138(Supplement 1):2418.
Patel NJ, D'Silva KM, Hsu TYT, et al. COVID-19 outcomes among users of CD20 inhibitors for immune-mediated diseases: a comparative cohort study. medRxiv 2021 Aug 9;2021.08.05.21261643. 2021.
Avouac J, Drumez E, Hachulla E, et al. COVID-19 outcomes in patients with inflammatory rheumatic and musculoskeletal diseases treated with rituximab: a cohort study. Lancet Rheumatol. 2021;3(6):e419-e426.