Publication Date:
2020-11-05
Description:
INTRODUCTION: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic raises many questions about the management of patients with significant comorbidities. Hematologic patients are usually fragile due to an important immunosuppression, so the impact of coronavirus disease (COVID-19) is yet to be determined. MATERIALS AND METHODS: We conducted a single-center retrospective observational study of patients with hematologic malignancies diagnosed with SARS-CoV-2 at Vall d´Hebron University Hospital (HUVH) between March 1st and May 31st 2020 to analyze their clinical characteristics and evolution. Patient's demographic data, underlying pathology, signs and symptoms of COVID-19, treatment received and clinical course were collected. A statistical analysis was performed to identify the possible variables associated with COVID-19 mortality. For this purpose, we used univariate and multivariable logistic regression models. RESULTS: We identified 70 patients with PCR confirmed SARS-CoV-2 infection and hematologic malignancy. The median age was 75 years (range 22-91), and 44% were female. The majority (74%) had evidence of active malignancy and 53% were receiving active therapy. Lymphoid pathology (73%) predominated over myeloid. The median number of previous lines of treatment was 0 (range 0-6), 23% had received at least 2 lines, whereas 10% underwent hematopoietic stem cell transplantation (HSCT) (5 patients allo-HSCT, 2 auto-HSCT). Half of the patients had more than one pre-existing comorbidity (17% obstructive pulmonary disease). At diagnosis the most common symptoms were fever (76%), cough (60%) and dyspnea (31%). We observed that 58% of patients presented a chest X-ray compatible with COVID-19. Regarding laboratory parameters, stood out lymphopenia (65% of patients presented 75 years (OR 1.07; p=0.008), active malignancy (OR 5; p=0,02), 〉1 comorbidity (OR 5.3; p=0,049) and high levels of IL-6 (OR 8.2; p= 0.005) were statistically significant. In the multivariable logistic regression model, age ≥75 years (OR 4.4; p=0.01) and IL-6 levels at baseline 〉 59.6 pg/mL (OR 7.2; p=0.01) were associated with a higher mortality (table 1). The presence of an active malignancy was not a significant variable in the multivariable logistic regression model. CONCLUSIONS: Patients with hematologic malignancies and COVID-19 presented similar symptoms, signs and radiological characteristics to those described in the general population at diagnosis. In our cohort, advanced age and high IL-6 values were associated with higher mortality. Furthermore, it was observed that active hematologic disease is a factor of poor prognosis of COVID-19. Disclosures Salamero: Daichii Sankyo:Honoraria;Celgene:Consultancy, Honoraria;Novartis:Consultancy, Honoraria;Jazz Pharmaceuticals:Consultancy, Honoraria;Pfizer:Consultancy.Abrisqueta:Janssen:Consultancy, Honoraria, Speakers Bureau;AbbVie:Consultancy, Honoraria, Speakers Bureau;Roche:Consultancy, Honoraria, Speakers Bureau;Celgene:Consultancy, Honoraria.Bosch:Hoffmann-La Roche:Research Funding.
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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