학술논문
Risk factors and outcome of COVID-19 in patients with hematological malignancies
Document Type
Academic Journal
Author
Piéana, José Luis; Martino, Rodrigo; García-García, Irene; Parody, Rocío; Morales, María Dolores; Benzo, Gonzalo; Gómez-Catalan, Irene; Coll, Rosa; De La Fuente, Ignacio; Luna, Alejandro; Merchán, Beatriz; Chinea, Anabelle; de Miguel, Dunia; Serrano, Ana; Pérez, Carmen; Diaz, Carola; Lopez, José Luis; Saez, Adolfo Jesús; Bailen, Rebeca; Zudaire, Teresa; Martínez, Diana; Jurado, Manuel; Calbacho, María; Vázquez, Lourdes; Garcia-Cadenas, Irene; Fox, Laura; Pimentel, Ana I.; Bautista, Guiomar; Nieto, Agustin; Fernandez, Pascual; Vallejo, Juan Carlos; Solano, Carlos; Valero, Marta; Espigado, Ildefonso; Saldaéa, Raquel; Sisinni, Luisa; Ribera, Josep Maria; Jimenez, Maria Jose; Trabazo, Maria; Gonzalez-Vicent, Marta; Fernández, Noemí; Talarn, Carme; Montoya, Maria Carmen; Cedillo, Angel; Sureda, Anna
Source
Experimental Hematology & Oncology. August 25, 2020, Vol. 9 Issue 1
Subject
Language
English
ISSN
2162-3619
Abstract
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.sup.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.
Author(s): José Luis Piéana[sup.1,2,36], Rodrigo Martino[sup.3], Irene García-García[sup.4], Rocío Parody[sup.5], María Dolores Morales[sup.6], Gonzalo Benzo[sup.7], Irene Gómez-Catalan[sup.8], Rosa Coll[sup.9], Ignacio De La Fuente[sup.10], Alejandro Luna[sup.4], Beatriz Merchán[sup.6], Anabelle Chinea[sup.4], Dunia [...]
Author(s): José Luis Piéana[sup.1,2,36], Rodrigo Martino[sup.3], Irene García-García[sup.4], Rocío Parody[sup.5], María Dolores Morales[sup.6], Gonzalo Benzo[sup.7], Irene Gómez-Catalan[sup.8], Rosa Coll[sup.9], Ignacio De La Fuente[sup.10], Alejandro Luna[sup.4], Beatriz Merchán[sup.6], Anabelle Chinea[sup.4], Dunia [...]