Clinical Characteristics and Outcomes of COVID-19 in Turkish Patients with Hematological Malignancies
Sinem Civriz Bozdağ, Güldane Cengiz Seval, İpek Yönal Hindilerden, Fehmi Hindilerden, Neslihan Andıç, Mustafa Baydar, Lale Aydın Kaynar, Selami Koçak Toprak, Hasan Sami Göksoy, Berrin Balık Aydın, Ufuk Demirci, Ferda Can, Vildan Özkocaman, Eren Gündüz, Zeynep Tuğba Güven, Zübeyde Nur Özkurt, Sinan Demircioğlu, Meral Beksaç, İdris İnce, Umut Yılmaz, Hilal Eroğlu Küçükdiler, Elgün Abishov, Boran Yavuz, Ünal Ataş, Yaşa Gül Mutlu, Volkan Baş, Fahir Özkalemkaş, Hava Üsküdar Teke, Vildan Gürsoy, Serhat Çelik, Rafiye Çiftçiler, Münci Yağcı, Pervin Topçuoğlu, Özcan Çeneli, Hamza Abbasov, Cem Selim, Muhlis Cem Ar, Orhan Kemal Yücel, Sevil Sadri, Canan Albayrak, Ahmet Muzaffer Demir, Nil Güler, Muzaffer Keklik, Hatice Terzi, Ali Doğan, Zeynep Arzu Yegin, Meltem Kurt Yüksel, Soğol Sadri, İrfan Yavaşoğlu, Hüseyin Saffet Beköz, Tekin Aksu, Senem Maral, Veysel Erol, Leylagül Kaynar, Osman İlhan, Ali Zahit Bolaman, Ömür Gökmen Sevindik, Arzu Akyay, Muhit Özcan, Günhan Gürman, Şule Ünal Cangül, Yasemin Yavuz, Reyhan Diz Küçükkaya, Güner Hayri Özsan
Turkish Journal of Hematology, doi:10.4274/tjh.galenos.2021.2021.0287
Patients with solid malignancies are more vulnerable to SARS-CoV-2 infection than healthy population. The outcome of SARS-CoV-2 infection in highly immunosupressed populations, such as in patients with hematological malignancies is a point of interest.We aimed to analyze the symptoms, complications, intensive care unit (ICU) admission and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. In this multicenter study, we included 340 adult and pediatric patients diagnosed as COVID-19 from March to November. Forty four (12.9%) patients were asymptomatic at diagnosis. In symptomatic patients, fever, cough and dyspnea were observed in 62.6%, 48.8 % and 41.8% of the patients, respectively. Sixty nine (20%) patients had mild SARS-Cov-2 disease, whereas moderate, severe and critical diseases were reported in 101 (29%), 71 (20%) and 55 (16%) patients, respectively. Two hundered fifty one (73.8%) patients were hospitalized for SARS-Cov2. Mortality related to SARS-CoV-2 infection was 26.5% in all cohort; 4.4% in those patients with mild disease, 12.4% in moderate disease and 83% in severe and critical disease. Active hematological disease, lower life expectancy related with primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission and firstline therapy used for COVID 19 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azitromycin were associated with a higher rate of mortality in comparison with favipiravir use.In conclusion, patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.
References
Bloomgarden, J Diabetes and COVID-19, J Diabetes
Boulware, Pullen, Bangdiwala, Pastick, Lofgren et al., A Randomized Trial of Hydroxychloroquine as Postexposure Prophylaxis for Covid-19
Cavalcanti, Zampieri, Rosa, Azevedo, Veiga et al., Coalition Covid-19 Brazil I Investigators. Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19, N Engl J Med
Chari, Samur, Martinez-Lopez, Cook, Biran et al., Clinical Features Associated with COVID-19 Outcome in MM: First Results from International Myeloma Society Dataset, Blood
Coomes, Haghbayan, Favipiravir, an antiviral for COVID-19?, J Antimicrob Chemother
Dai, Liu, Liu, Zhou, Li et al., Patients with Cancer Appear More Vulnerable to SARS-CoV-2: A Multicenter Study during the COVID-19 Outbreak, Cancer Discov
Ferrara, Zappasodi, Roncoroni, Borlenghi, Rossi, Impact of Covid-19 on the treatment of acute myeloid leukemia, Leukemia
Fj, COVID-19, hypertension and angiotensin receptor-blocking drugs, J Hypertens
Fontana, Strasfeld, Respiratory Virus Infections of the Stem Cell Transplant Recipient and the Hematologic Malignancy Patient, Infect Dis Clin North Am
García-Suárez, De La Cruz, Cedillo, Llamas, Duarte et al., Asociación Madrileña de Hematología y Hemoterapia (AMHH). Impact of hematological malignancy and type of cancer therapy on COVID-19 severity and mortality:lessons from a large population based registy study, J Hematol Oncol
He, Chen, Chen, Yuan, Fang et al., COVID-19 in persons with haematological cancers, Leukemia
Joshi, Parkar, Ansari, Vora, Talwar et al., Role of favipiravir in the treatment of COVID-19, Int J Infect Dis
Khawaja, Chemaly, Respiratory syncytial virus in hematopoietic cell transplant recipients and patients with hematologic malignancies, Haematologica
Leung, Niikura, Yang, Sin, COVID-19 and COPD, Eur Respir J
Liang, Guan, Chen, Li, Xu et al., Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China, Lancet Oncol
Malard, Genthon, Brissot, Van De Wyngaert, Marjanovic et al., Bone Marrow Transplant. COVID-19 outcomes in patients with hematologic disease
Martín-Moro, Marquet, Piris, Michael, Sáez et al., Survival study of hospitalised patients with concurrent COVID-19 and haematological malignancies
Passamonti, Cattaneo, Arcaini, Bruna, Cavo 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
Piñana, Martino, García-García, Parody, Morales et al., Infectious Complications Subcommittee of the Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH). Risk factors and outcome of COVID-19 in patients with hematological malignancies, Exp Hematol Oncol
Recovery Collaborative Group, Horby, Mafham, Linsell, Bell et al., -Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19, N Engl J Med
Rodgers, Gibbons, Obesity and Hypertension in the Time of COVID-19, JAMA
Rossi, Shah, Shrestha, Stanca, Stavroyianni et al., COVID-19 severity and mortality in patients with chronic lymphocytic leukemia: a joint study by ERIC, the European Research Initiative on CLL, and CLL Campus, Leukemia
Sahu, Siddiqui, Cerny, COVID-19 pandemic and impact on hematopoietic stem cell transplantation, Bone Marrow Transplant
Scarfò, Chatzikonstantinou, Rigolin, Quaresmini, Motta et al., None
Siddiqi, Mehra, COVID-19 illness in native and immunosuppressed states: a clinical-therapeutic staging proposal, J Heart Lung Transplant
Terpos, Engelhardt, Cook, Gay, Mateos et al., Leukemia. Management of patients with multiple myeloma in the era of COVID-19 pandemic: a consensus paper from the European Myeloma Network, EMN)
Tugce, Yigenoglu, Bascı, Dal, Korkmaz et al., -The outcome of COVID-19 in patients with hematological malignancy, J Med Virol
Vijenthira, Gong, Fox, Booth, Cook et al., Outcomes of patients with hematologic malignancies and COVID-19: A systematic review and meta-analysis of 3377 patients, Blood
Xia, Zhao, Li, Shen, Risk of COVID-19 for patients with cancer, Lancet Oncol
