COVID-19 in adult acute myeloid leukemia patients: a long-term follow-up study from the European Hematology Association survey (EPICOVIDEHA)
Authors: Marchesi Francesco , Salmanton-García Jon , Emarah Ziad , Piukovics Klára , Nucci Marcio , López-García Alberto , Ráčil Zdeněk , Farina Francesca , Popova Marina , Zompi Sofia , Audisio Ernesta , Ledoux Marie-Pierre , Verga Luisa , Weinbergerová Barbora , Szotkovski Tomas , Da Silva Maria Gomes , Fracchiolla Nicola , De Jonge Nick , Collins Graham , Marchetti Monia , Magliano Gabriele , García-Vidal Carolina , Biernat Monika M. , Van Doesum Jaap , Machado Marina , Demirkan Fatih , Al-Khabori Murtadha , Žák Pavel , Víšek Benjamín , Stoma Igor , Méndez Gustavo-Adolfo , Maertens Johan , Khanna Nina , Espigado Ildefonso , Dragonetti Giulia , Fianchi Luana , Del Principe Maria Ilaria , Cabirta Alba , Ormazabal-Vélez Irati , Jaksic Ozren , Buquicchio Caterina , Bonuomo Valentina , Batinić Josip , Omrani Ali S. , Lamure Sylvain , Finizio Olimpia , Fernández Noemí , Falces-Romero Iker , Blennow Ola , Bergantim Rui , Ali Natasha , Win Sein , Van Praet Jens , Tisi Maria Chiara , Shirinova Ayten , Schönlein Martin , Prattes Juergen , Piedimonte Monica , Petzer Verena , Navrátil Milan , Kulasekararaj Austin , Jindra Pavel , Sramek Jiří , Glenthøj Andreas , Fazzi Rita , De Ramón-Sánchez Cristina , Cattaneo Chiara , Calbacho Maria , Bahr Nathan C. , El-Ashwah Shaimaa , Cordoba Raul , Hanakova Michaela , Zambrotta Giovanni , Sciumè Mariarita , Booth Stephen , Rodrigues Raquel Nunes , Sacchi Maria Vittoria , García-Poutón Nicole , Martín-González Juan-Alberto , Khostelidi Sofya , Gräfe Stefanie , Rahimli Laman , Ammatuna Emanuele , Busca Alessandro , Corradini Paolo , Hoenigl Martin , Klimko Nikolai , Koehler Philipp , Pagliuca Antonio , Passamonti Francesco , Cornely Oliver A. , Pagano Livio 
Published: May 2022

Patients with acute myeloid leukemia (AML) are at high risk of dying from coronavirus disease 2019 (COVID-19). The optimal management of AML patients with COVID-19 has not been established. Our multicenter study included 388 adult AML patients diagnosed with COVID-19 between February 2020 and October 2021. The vast majority were receiving or had received AML treatment in the preceding 3 months. COVID-19 was severe in 41.2% and critical in 21.1% of cases. The chemotherapeutic schedule was modified in 174 patients (44.8%), delayed in 68 and permanently discontinued in 106. After a median follow-up of 325 days, 180 patients (46.4%) had died; death was attributed to COVID-19 (43.3%), AML (26.1%) or to a combination of both (26.7%), whereas in 3.9% of cases the reason was unknown. Active disease, older age, and treatment discontinuation were associated with death, whereas AML treatment delay was protective. Seventy-nine patients had a simultaneous AML and COVID-19 diagnosis, with better survival when AML treatment could be delayed (80%; P<0.001). Overall survival in patients with a diagnosis of COVID-19 between January 2020 and August 2020 was significantly lower than that in patients diagnosed between September 2020 and February 2021 and between March 2021 and September 2021 (39.8% vs. 60% vs. 61.9%, respectively; P=0.006). COVID-19 in AML patients was associated with a high mortality rate and modifications of therapeutic algorithms. The best approach to improve survival was to delay AML treatment, whenever possible.