Risk factors and outcome of COVID-19 in patients with hematological malignancies
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xperimental Hematology & Oncology Open Access
RESEARCH
Risk factors and outcome of COVID‑19 in patients with hematological malignancies José Luis Piñana1,2,36* , Rodrigo Martino3, Irene García‑García4, Rocío Parody5, María Dolores Morales6, Gonzalo Benzo7, Irene Gómez‑Catalan8, Rosa Coll9, Ignacio De La Fuente10, Alejandro Luna4, Beatriz Merchán6, Anabelle Chinea4, Dunia de Miguel6, Ana Serrano8, Carmen Pérez10, Carola Diaz11, José Luis Lopez12, Adolfo Jesús Saez4, Rebeca Bailen13, Teresa Zudaire14, Diana Martínez15, Manuel Jurado16, María Calbacho17, Lourdes Vázquez18, Irene Garcia‑Cadenas3, Laura Fox19, Ana I. Pimentel20, Guiomar Bautista21, Agustin Nieto22, Pascual Fernandez23, Juan Carlos Vallejo24, Carlos Solano25, Marta Valero26, Ildefonso Espigado27, Raquel Saldaña28, Luisa Sisinni29, Josep Maria Ribera30, Maria Jose Jimenez30, Maria Trabazo31, Marta Gonzalez‑Vicent32, Noemí Fernández33, Carme Talarn34, Maria Carmen Montoya8, Angel Cedillo35 and Anna Sureda5 on behalf of Infectious Complications Subcommittee of the Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH)
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% con‑ fidence interval (CI) 1.2–3.8, p = 0.011]; uncontrolled hematological malignancy (OR 2.9, 95% CI 1.6–5.2, p 92%. Stage IIB included patients meeting the IIA criteria but who required oxygen support (i.e., patients with acute respiratory failure). Finally,
Piñana et al. Exp Hematol Oncol
(2020) 9:21
we did not classify cases as stage III since we did not have sufficient inflammatory blood markers in all cases, which are required for upgrading a stage IIB to a stage III. Patients with stage IIB thus comprise all patients with severe COVID-19, while stage IIA can be considered to have moderate COVID-19. We considered very severe COVID-19 those who developed stage IIB and those who required ICU admission due to respiratory failure and/or hemodynamic instability. Disease status at the time of SARS-CoV-2 detection was defined according to each specific disease’s revised criteria for leukemia, myeloproliferative neoplasm, multiple myelom
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