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COVID-19 OUTCOMES OF PATIENTS WITH HEMATOLOGIC MALIGNANCIES: A SINGLE CENTER EXPERIENCE
Author(s): ,
Nikolaos Spyridis
Affiliations:
Hematology Department - HCT Unit,G.Papanikolaou Hospital,Thessaloniki,Greece
,
Despoina Mallouri
Affiliations:
Hematology Department - HCT Unit,G.Papanikolaou Hospital,Thessaloniki,Greece
,
Thomas Chatzikonstantinou
Affiliations:
Hematology Department - HCT Unit,G.Papanikolaou Hospital,Thessaloniki,Greece
,
Christos Demosthenous
Affiliations:
Hematology Department - HCT Unit,G.Papanikolaou Hospital,Thessaloniki,Greece
,
Niki Stavroyianni
Affiliations:
Hematology Department - HCT Unit,G.Papanikolaou Hospital,Thessaloniki,Greece
,
Aygi Lalayanni
Affiliations:
Hematology Department - HCT Unit,G.Papanikolaou Hospital,Thessaloniki,Greece
,
Ioannis Batsis
Affiliations:
Hematology Department - HCT Unit,G.Papanikolaou Hospital,Thessaloniki,Greece
,
Ioanna Sakellari
Affiliations:
Hematology Department - HCT Unit,G.Papanikolaou Hospital,Thessaloniki,Greece
,
Achilles Anagnostopoulos
Affiliations:
Hematology Department - HCT Unit,G.Papanikolaou Hospital,Thessaloniki,Greece
Damianos Sotiropoulos
Affiliations:
Hematology Department - HCT Unit,G.Papanikolaou Hospital,Thessaloniki,Greece
EHA Library. Spyridis N. 06/09/21; 324260; PB1583
Nikolaos Spyridis
Nikolaos Spyridis
Contributions
Abstract

Abstract: PB1583

Type: Publication Only

Session title: Infections in hematology (incl. supportive care/therapy)

Background
SARS-CoV-2 is a novel coronavirus causing an infection, named Coronavirus Disease 2019 (COVID-19). As of February 22, 2021, the virus had affected more than 112 millions individuals and resulted in over 2,4 millions deaths worldwide. Mortality can be as high as 15% in elderly patients, and/or in patients with comorbidities. Data from studies suggest that patients with cancer have a higher incidence of severe events after contacting the virus. Very few data are available on COVID-19 outcomes in patients with hematologic diseases who are highly immunocompromised due to their underlying disease and the treatments they receive, with high risk of morbidity and mortality from COVID-19.

Aims
The purpose of this study was to perform a review to quantify the outcomes (hospitalizations and deaths) of patients with hematologic malignancy and COVID-19.

Methods
Our department consists of Hematology Clinic and BMT Unit. We included patients with a hematologic disease, with laboratory-confirmed COVID-19 infection between October 2020 and February 2021. A confirmed case of COVID-19 was defined by a positive result on RT-PCR assay. We reviewed hematological medical records to collect demographic, clinical, and treatment data and outcomes of COVID-19. We evaluated 73 patients (43 male, 30 female, median age 61). Information extracted included total number of patients, coronavirus symptoms, hospital admission rate, death rate. Hematologic malignancy subtypes were: acquired bone marrow failure syndromes; acute leukemias; lymphomas; chronic lymphocytic leukemia; plasma cell dyscrasias; MPNs; other hematologic conditions; stem cell transplantation.

Results

According to our analysis, regarding COVID-19 symptoms at diagnosis, 47 of 73 pts (64%) presented fever, as single symptom or combined with at least one more symptom, 20 of 73 pts (27%) presented two or more symptoms, including anosmia, cough, shortness of breath, myalgias, fatigue, while 9 of 73 pts (12%) were asymptomatic and diagnosis confirmed only with positive PCR test. Patients presented with moderate or severe COVID-19 were 28 of 73 (38%), while 9 of 28 hospitalized pts (32%) required Intensive Care Unit (ICU) admission.


Data collected regarding hematologic malignancy subtype showed: lymphomas, non including CLL, 24 of 73 pts (33%), CLL, 17 of 73 pts (23%), acute leukemias, 7 of 73 pts (10%), MPNs, 8 of 73 pts (11%), acquired bone marrow failure syndromes, 5 of 73 pts (7%), multiple myeloma, 3 of 73 pts (4%), other hematologic conditions 5 of 73 (7%), while patients who underwent transplantation were 4 of 73 (5%). Regarding treatment, patients divided in two subgroups, 52 of 73 (71%) received anticancer therapy at some time in their lives, while 21 of 73 pts (29%) have never been on treatment.


Total death rate was 23% (17 of 73 pts), while among hospitalized pts was nearly 54% (15 of 28), with all patients requiring ICU not surviving (9 of 9, rate 100%). 2 of 17 pts (11%) died without hospitalization. Death rate in CLL pts was 41% (7 of 17 pts) with 2 of 17 (11%) not on treatment, in lymphomas 16% (4 of 24 pts), while in other hematologic subgroups were reported from 1 to 2 deaths per group.

Conclusion
Hematological patients appear to be a population very vulnerable to COVID-19 infection, with significant morbidity and mortality. More data are necessary in further surveys from more centers and larger number of patients. Hematology departments should remain COVID-19 free zones dedicated only to hematologic treatment and patients should strictly comply with social distancing.

Keyword(s): COVID-19, Hematological malignancy

Abstract: PB1583

Type: Publication Only

Session title: Infections in hematology (incl. supportive care/therapy)

Background
SARS-CoV-2 is a novel coronavirus causing an infection, named Coronavirus Disease 2019 (COVID-19). As of February 22, 2021, the virus had affected more than 112 millions individuals and resulted in over 2,4 millions deaths worldwide. Mortality can be as high as 15% in elderly patients, and/or in patients with comorbidities. Data from studies suggest that patients with cancer have a higher incidence of severe events after contacting the virus. Very few data are available on COVID-19 outcomes in patients with hematologic diseases who are highly immunocompromised due to their underlying disease and the treatments they receive, with high risk of morbidity and mortality from COVID-19.

Aims
The purpose of this study was to perform a review to quantify the outcomes (hospitalizations and deaths) of patients with hematologic malignancy and COVID-19.

Methods
Our department consists of Hematology Clinic and BMT Unit. We included patients with a hematologic disease, with laboratory-confirmed COVID-19 infection between October 2020 and February 2021. A confirmed case of COVID-19 was defined by a positive result on RT-PCR assay. We reviewed hematological medical records to collect demographic, clinical, and treatment data and outcomes of COVID-19. We evaluated 73 patients (43 male, 30 female, median age 61). Information extracted included total number of patients, coronavirus symptoms, hospital admission rate, death rate. Hematologic malignancy subtypes were: acquired bone marrow failure syndromes; acute leukemias; lymphomas; chronic lymphocytic leukemia; plasma cell dyscrasias; MPNs; other hematologic conditions; stem cell transplantation.

Results

According to our analysis, regarding COVID-19 symptoms at diagnosis, 47 of 73 pts (64%) presented fever, as single symptom or combined with at least one more symptom, 20 of 73 pts (27%) presented two or more symptoms, including anosmia, cough, shortness of breath, myalgias, fatigue, while 9 of 73 pts (12%) were asymptomatic and diagnosis confirmed only with positive PCR test. Patients presented with moderate or severe COVID-19 were 28 of 73 (38%), while 9 of 28 hospitalized pts (32%) required Intensive Care Unit (ICU) admission.


Data collected regarding hematologic malignancy subtype showed: lymphomas, non including CLL, 24 of 73 pts (33%), CLL, 17 of 73 pts (23%), acute leukemias, 7 of 73 pts (10%), MPNs, 8 of 73 pts (11%), acquired bone marrow failure syndromes, 5 of 73 pts (7%), multiple myeloma, 3 of 73 pts (4%), other hematologic conditions 5 of 73 (7%), while patients who underwent transplantation were 4 of 73 (5%). Regarding treatment, patients divided in two subgroups, 52 of 73 (71%) received anticancer therapy at some time in their lives, while 21 of 73 pts (29%) have never been on treatment.


Total death rate was 23% (17 of 73 pts), while among hospitalized pts was nearly 54% (15 of 28), with all patients requiring ICU not surviving (9 of 9, rate 100%). 2 of 17 pts (11%) died without hospitalization. Death rate in CLL pts was 41% (7 of 17 pts) with 2 of 17 (11%) not on treatment, in lymphomas 16% (4 of 24 pts), while in other hematologic subgroups were reported from 1 to 2 deaths per group.

Conclusion
Hematological patients appear to be a population very vulnerable to COVID-19 infection, with significant morbidity and mortality. More data are necessary in further surveys from more centers and larger number of patients. Hematology departments should remain COVID-19 free zones dedicated only to hematologic treatment and patients should strictly comply with social distancing.

Keyword(s): COVID-19, Hematological malignancy

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