Risk factors and outcome of COVID-19 in patients with hematological malignancies

被引：128

作者：

Pinana, Jose Luis ^{[1
,2
,3
,6
,36
]}

Martino, Rodrigo ^{[3
]}

Garcia-Garcia, Irene ^{[4
]}

Parody, Rocio ^{[5
]}

Morales, Maria Dolores ^{[6
]}

Benzo, Gonzalo ^{[7
]}

Gomez-Catalan, Irene ^{[8
]}

Coll, Rosa ^{[9
]}

De la Fuente, Ignacio ^{[10
]}

Luna, Alejandro ^{[4
]}

Merchan, Beatriz ^{[6
]}

Chinea, Anabelle ^{[4
]}

de Miguel, Dunia ^{[6
]}

Serrano, Ana ^{[8
]}

Perez, Carmen ^{[10
]}

Diaz, Carola ^{[11
]}

Lopez, Jose Luis ^{[12
]}

Saez, Adolfo Jesus ^{[4
]}

Bailen, Rebeca ^{[13
]}

Zudaire, Teresa ^{[14
]}

Martinez, Diana ^{[15
]}

Jurado, Manuel ^{[16
]}

Calbacho, Maria ^{[17
]}

Vazquez, Lourdes ^{[18
]}

Garcia-Cadenas, Irene ^{[3
]}

Fox, Laura ^{[19
]}

Pimentel, Ana I. ^{[20
]}

Bautista, Guiomar ^{[21
]}

Nieto, Agustin ^{[22
]}

Fernandez, Pascual ^{[23
]}

Vallejo, Juan Carlos ^{[24
]}

Solano, Carlos ^{[25
]}

Valero, Marta ^{[26
]}

Espigado, Ildefonso ^{[27
]}

Saldana, Raquel ^{[28
]}

Sisinni, Luisa ^{[29
]}

Ribera, Josep Maria ^{[30
]}

Jimenez, Maria Jose ^{[30
]}

Trabazo, Maria ^{[31
]}

Gonzalez-Vicent, Marta ^{[32
]}

Fernandez, Noemi ^{[33
]}

Talarn, Carme ^{[34
]}

Montoya, Maria Carmen ^{[8
]}

Cedillo, Angel ^{[35
]}

Sureda, Anna ^{[5
]}

机构：

[1] Hosp Univ & Politecn La Fe, Inst Invest Sanit La Fe, Hematol Div, Valencia, Spain

[2] Inst Carlos III, CIBERONC, Madrid, Spain

[3] Hosp Santa Creu Sant & Pau, Hematol Div, Barcelona, Spain

[4] Hosp Ramon & Cajal, Hematol Div, Madrid, Spain

[5] Hosp Duran & Reynals, Hematol Div, Inst Catala Oncol, Barcelona, Spain

[6] Hosp Guadalajara, Hematol Div, Guadalajara, Spain

[7] Hosp La Princesa, Hematol Div, Madrid, Spain

[8] Hosp Albacete, Hematol Div, Albacete, Spain

[9] Hosp Josep Trueta, Hematol Div, Inst Catala Oncol, Girona, Spain

[10] Hosp Clin Valladolid, Hematol Div, Valladolid, Spain

[11] Hosp Carlos Haya, Hematol Div, Malaga, Spain

[12] Hosp Fdn Jimenez Diaz, Hematol Div, Madrid, Spain

[13] Hosp Gregorio Maranon, Hematol Div, Madrid, Spain

[14] Hosp Navarra, Hematol Div, Navarra, Spain

[15] Hosp Coruna, Hematol Div, Coruna, Spain

[16] Hosp Virgen Nieves, Hematol Div, Granada, Spain

[17] Hosp 12 Octubre, Hematol Div, Madrid, Spain

[18] Hosp Univ Salamanca, Hematol Div, Salamanca, Spain

[19] Hosp Valle De Hebron, Hematol Div, Barcelona, Spain

[20] Hosp Clin Univ Lozano Blesa, IIS Aragon, Hematol Div, Zaragoza, Spain

[21] Hosp Puerta Hierro, Hematol Div, Madrid, Spain

[22] Hosp Vigo, Hematol Div, Vigo, Spain

[23] Hosp Gen Alicante, Hematol Div, Alicante, Spain

[24] Hosp Donostia, Hematol Div, Donostia San Sebastian, Spain

[25] Hosp Clin Univ Valencia, Hematol Div, Valencia, Spain

[26] Hosp Arnau Vilanova, Hematol Div, Valencia, Spain

[27] Univ Seville, CSIC, Univ Hosp Virgen Rocio, Dept Hematol,Inst Biomed Sevilla, Seville, Spain

[28] Hosp Jerez, Hematol Div, Jerez de la Frontera, Spain

[29] Hosp Paz, Pediat Hematol Oncol Div, Madrid, Spain

[30] Hosp Badalona Germans Trias & Pujol, Josep Carreras Res Inst, ICO, Hematol Div, Badalona, Spain

[31] Hosp Santa Creu & Sant Pau, Pediat Div, Barcelona, Spain

[32] Hosp Nino Jesus, Pediat Div, Madrid, Spain

[33] Hosp Marques Valdecilla, Hematol Div, Santander, Spain

[34] Hosp Joan 23, Hematol Div, Tarragona, Spain

[35] Hematopoiet Stem Cell Transplantat & Cell Therapy, Madrid, Spain

[36] Hosp Univ Fe Valencia, Div Clin Hematol, Avda Fernando Abril Martorell 106, Valencia 46026, Spain

来源：

EXPERIMENTAL HEMATOLOGY & ONCOLOGY | 2020年 / 9卷 / 01期

关键词：

SARS-COV-2; RECOMMENDATIONS; MANAGEMENT; CRITERIA;

D O I：

10.1186/s40164-020-00177-z

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background Prognostic factors of poor outcome in patients with hematological malignancies and COVID-19 are poorly defined. Patients and methods This was a Spanish transplant group and cell therapy (GETH) multicenter retrospective observational study, which included a large cohort of blood cancer patients with laboratory-confirmed SARS-CoV-2 infection through PCR assays from March 1st 2020 to May 15th 2020. Results We included 367 pediatric and adult patients with hematological malignancies, including recipients of autologous (ASCT) (n = 58) or allogeneic stem cell transplantation (allo-SCT) (n = 65) from 41 hospitals in Spain. Median age of patients was 64 years (range 1-93.8). Recipients of ASCT and allo-SCT showed lower mortality rates (17% and 18%, respectively) compared to non-SCT patients (31%) (p = 0.02). Prognostic factors identified for day 45 overall mortality (OM) by logistic regression multivariate analysis included age > 70 years [odds ratio (OR) 2.1, 95% confidence interval (CI) 1.2-3.8, p = 0.011]; uncontrolled hematological malignancy (OR 2.9, 95% CI 1.6-5.2, p < 0.0001); ECOG 3-4 (OR, 2.56, 95% CI 1.4-4.7, p = 0.003); neutropenia (< 0.5 x 10(9)/L) (OR 2.8, 95% CI 1.3-6.1, p = 0.01); and a C-reactive protein (CRP) > 20 mg/dL (OR 3.3, 95% CI 1.7-6.4, p < 0.0001). In multivariate analysis of 216 patients with very severe COVID-19, treatment with azithromycin or low dose corticosteroids was associated with lower OM (OR 0.42, 95% CI 0.2-0.89 and OR 0.31, 95% CI 0.11-0.87, respectively, p = 0.02) whereas the use of hidroxycloroquine did not show significant improvement in OM (OR 0.64, 95% CI 0.37-1.1, P = 0.1). Conclusions In most patients with hematological malignancies COVID-19 mortality was directly driven by older age, disease status, performance status, as well as by immune (neutropenia) parameters and level of inflammation (high CRP). Use of azithromycin and low dose corticosteroids may be of value in very severe COVID-19.

引用

页数：16

共 50 条

[1] Risk factors and outcome of COVID-19 in patients with hematological malignancies
José Luis Piñana
Rodrigo Martino
Irene García-García
Rocío Parody
María Dolores Morales
Gonzalo Benzo
Irene Gómez-Catalan
Rosa Coll
Ignacio De La Fuente
Alejandro Luna
Beatriz Merchán
Anabelle Chinea
Dunia de Miguel
Ana Serrano
Carmen Pérez
Carola Diaz
José Luis Lopez
Adolfo Jesús Saez
Rebeca Bailen
Teresa Zudaire
Diana Martínez
Manuel Jurado
María Calbacho
Lourdes Vázquez
Irene Garcia-Cadenas
Laura Fox
Ana I. Pimentel
Guiomar Bautista
Agustin Nieto
Pascual Fernandez
Juan Carlos Vallejo
Carlos Solano
Marta Valero
Ildefonso Espigado
Raquel Saldaña
Luisa Sisinni
Josep Maria Ribera
Maria Jose Jimenez
Maria Trabazo
Marta Gonzalez-Vicent
Noemí Fernández
Carme Talarn
Maria Carmen Montoya
Angel Cedillo
Anna Sureda
[J]. Experimental Hematology & Oncology, 9
[2] Clinical manifestations and risk factors for COVID-19 and its severity in patients with hematological malignancies
Wu, Tzong-Yow
Tsai, Wan-Ting
Chen, Kai-Hsiang
Huang, Szu-Ting
Huang, Chun-Fu
Kuo, Po-Hsien
Tsai, Ming-Jui
Liu, Wang-Da
Lin, Kuan-Yin
Huang, Yu-Shan
Cheng, Aristine
Chen, Pao-Yu
Sun, Hsin-Yun
Huang, Huai-Hsuan
Huang, Tai-Chung
Wu, Shang-Ju
Yao, Ming
Wang, Jann-Tay
Sheng, Wang-Huei
Hung, Chien-Ching
Chen, Yee-Chun
Chang, Shan-Chwen
[J]. JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION, 2024, 57 (03) : 403 - 413
[3] A Comparative Outcome Analysis of COVID-19 and Influenza Infection in Patients with Hematological Malignancies
Ghandili, Susanne
Niederwieser, Christian
Weisel, Katja
Bokemeyer, Carsten
Fiedler, Walter
Modemann, Franziska
[J]. BLOOD, 2021, 138
[4] COVID-19 IN HEMATOLOGICAL MALIGNANCIES
Passamonti, F.
[J]. HAEMATOLOGICA, 2021, 106 (10) : 231 - 232
[5] Effect of age, comorbidity and remission status on outcome of COVID-19 in patients with hematological malignancies
Borah, Pronamee
Mirgh, Sumeet
Sharma, Sanjeev Kumar
Bansal, Sachin
Dixit, Ashish
Dolai, Tuphan Kanti
Lunkad, Sweta
Gupta, Naveen
Singh, Gurmeet
Jain, Aditi
Bansal, Divya
Choudhary, Dharma
Khandelwal, Vipin
Doval, Divya
Kumar, Meet
Bhargava, Rahul
Chakrabarti, Amrita
Kalashetty, Mallikarjun
Rauthan, Amit
Kazi, Bilal
Mandal, Prakas Kumar
Jeyaraman, Preethi
Naithani, Rahul
[J]. BLOOD CELLS MOLECULES AND DISEASES, 2021, 87
[6] The outcome of COVID-19 in patients with hematological malignancy
Yigenoglu, Tugce N.
Ata, Naim
Altuntas, Fevzi
Basci, Semih
Dal, Mehmet Sinan
Korkmaz, Serdal
Namdaroglu, Sinem
Basturk, Abdulkadir
Hacibekiroglu, Tuba
Dogu, Mehmet H.
Dal, Kursat
Erkurt, Mehmet A.
Turgut, Burhan
Ulgu, Mustafa Mahir
Celik, Osman
Imrat, Ersan
Birinci, Suayip
[J]. JOURNAL OF MEDICAL VIROLOGY, 2021, 93 (02) : 1099 - 1104
[7] The outcome of COVID-19 in patients with hematological malignancy
Tiglioglu, Pinar
Albayrak, Murat
Tiglioglu, Mesut
Ozturk, Hacer Berna Afacan
Aras, Merih Reis
Saglam, Bugra
Maral, Senem
[J]. MEMO-MAGAZINE OF EUROPEAN MEDICAL ONCOLOGY, 2022, 15 (01) : 83 - 89
[8] The outcome of COVID-19 in patients with hematological malignancy
Pınar Tığlıoğlu
Murat Albayrak
Mesut Tığlıoğlu
Hacer Berna Afacan Öztürk
Merih Reis Aras
Buğra Sağlam
Senem Maral
[J]. memo - Magazine of European Medical Oncology, 2022, 15 : 83 - 89
[9] The outcome of COVID-19 in patients with hematological malignancy
Yigenoglu, Tugce N.
Basci, Semih
Dal, Mehmet S.
Korkmaz, Serdal
Turgut, Burhan
Altuntas, Fevzi
[J]. JOURNAL OF MEDICAL VIROLOGY, 2021, 93 (03) : 1255 - 1255
[10] The course of COVID-19 in patients with hematological malignancies and risk factors affecting mortality: A cross-sectional study
Eryilmaz-Eren, Esma
Ture, Zeynep
Kilinc-Toker, Aysin
Korkmaz, Serdal
Celik, Ilhami
[J]. HEMATOLOGY TRANSFUSION AND CELL THERAPY, 2024, 46 (01) : 3 - 7

← 1 2 3 4 5 →