COVID-19 severity and mortality in patients with CLL: an update of the international ERIC and Campus CLL study
Authors: Chatzikonstantinou Thomas , Kapetanakis Anargyros , Scarfò Lydia , Karakatsoulis Georgios , Allsup David , Cabrero Alejandro Alonso , Andres Martin , Antic Darko , Baile Mónica , Baliakas Panagiotis , Bron Dominique , Capasso Antonella , Chatzileontiadou Sofia , Cordoba Raul , Correa Juan-Gonzalo , Cuéllar-García Carolina , De Paoli Lorenzo , De Paolis Maria Rosaria , Del Poeta Giovanni , Demosthenous Christos , Dimou Maria , Donaldson David , Doubek Michael , Efstathopoulou Maria , Eichhorst Barbara , El-Ashwah Shaimaa , Enrico Alicia , Espinet Blanca , Farina Lucia , Ferrari Angela , Foglietta Myriam , Frederiksen Henrik , Fürstenau Moritz , García-Marco José A. , García-Serra Rocío , Gentile Massimo , Gimeno Eva , Glenthøj Andreas , Gomes da Silva Maria , Gutwein Odit , Hakobyan Yervand K. , Herishanu Yair , Hernández-Rivas José Ángel , Herold Tobias , Innocenti Idanna , Itchaki Gilad , Jaksic Ozren , Janssens Ann , Kalashnikova Оlga B. , Kalicińska Elżbieta , Karlsson Linda Katharina , Kater Arnon P. , Kersting Sabina , Labrador Jorge , Lad Deepesh , Laurenti Luca , Levin Mark-David , Lista Enrico , Lopez-Garcia Alberto , Malerba Lara , Marasca Roberto , Marchetti Monia , Marquet Juan , Mattsson Mattias , Mauro Francesca R. , Milosevic Ivana , Mirás Fatima , Morawska Marta , Motta Marina , Munir Talha , Murru Roberta , Niemann Carsten U. , Rodrigues Raquel Nunes , Olivieri Jacopo , Orsucci Lorella , Papaioannou Maria , Pavlovsky Miguel Arturo , Piskunova Inga , Popov Viola Maria , Quaglia Francesca Maria , Quaresmini Giulia , Qvist Kristian , Reda Gianluigi , Rigolin Gian Matteo , Ruchlemer Rosa , Saghumyan Gevorg , Shrestha Amit , Šimkovič Martin , Špaček Martin , Sportoletti Paolo , Stanca Oana , Stavroyianni Niki , Tadmor Tamar , Te Raa Doreen , Tonino Sanne H. , Trentin Livio , Van Der Spek Ellen , van Gelder Michel , van Kampen Roel , Varettoni Marzia , Visentin Andrea , Vitale Candida , Wasik-Szczepanek Ewa , Wróbel Tomasz , San Segundo Lucrecia Yáñez , Yassin Mohamed , Coscia Marta , Rambaldi Alessandro , Montserrat Emili , Foà Robin , Cuneo Antonio , Stamatopoulos Kostas , Ghia Paolo 
Published: November 2021

Patients with chronic lymphocytic leukemia (CLL) may be more susceptible to Coronavirus disease 2019 (COVID-19) due to age, disease, and treatment-related immunosuppression. We aimed to assess risk factors of outcome and elucidate the impact of CLL-directed treatments on the course of COVID-19. We conducted a retrospective, international study, collectively including 941 patients with CLL and confirmed COVID-19. Data from the beginning of the pandemic until March 16, 2021, were collected from 91 centers. The risk factors of case fatality rate (CFR), disease severity, and overall survival (OS) were investigated. OS analysis was restricted to patients with severe COVID-19 (definition: hospitalization with need of oxygen or admission into an intensive care unit). CFR in patients with severe COVID-19 was 38.4%. OS was inferior for patients in all treatment categories compared to untreated (p < 0.001). Untreated patients had a lower risk of death (HR = 0.54, 95% CI:0.41–0.72). The risk of death was higher for older patients and those suffering from cardiac failure (HR = 1.03, 95% CI:1.02–1.04; HR = 1.79, 95% CI:1.04–3.07, respectively). Age, CLL-directed treatment, and cardiac failure were significant risk factors of OS. Untreated patients had a better chance of survival than those on treatment or recently treated.