COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA)
Authors: Livio Pagano, Jon Salmanton-García, Francesco Marchesi, Alessandro Busca, Paolo Corradini, Martin Hoenigl, Nikolai Klimko, Philipp Koehler, Antonio Pagliuca, Francesco Passamonti, Luisa Verga, Benjamin Víšek, Osman Ilhan, Gianpaolo Nadali, Barbora Weinbergerová, Raúl Córdoba-Mascuñano, Monia Marchetti, Graham P. Collins, Francesca Farina, Chiara Cattaneo, Alba Cabirta, Maria Gomes-Silva, Federico Itri, Jaap van Doesum, Marie-Pierre Ledoux, Martin Čerňan, Ozren Jakšić, Rafael F. Duarte, Gabriele Magliano, Ali S. Omrani, Nicola S. Fracchiolla, Austin Kulasekararaj, Toni Valković, Christian Bjørn Poulsen, Marina Machado, Andreas Glenthøj, Igor Stoma, Zdeněk Ráčil, Klára Piukovics, Milan Navrátil, Ziad Emarah, Uluhan Sili, Johan Maertens, Ola Blennow, Rui Bergantim, Carolina García-Vidal, Lucia Prezioso, Anna Guidetti, Maria Ilaria del Principe, Marina Popova, Nick de Jonge, Irati Ormazabal-Vélez, Noemí Fernández, Iker Falces-Romero, Annarosa Cuccaro, Stef Meers, Caterina Buquicchio, Darko Antić, Murtadha Al-Khabori, Ramón García-Sanz, Monika M. Biernat, Maria Chiara Tisi, Ertan Sal, Laman Rahimli, Natasa Čolović, Martin Schönlein, Maria Calbacho, Carlo Tascini, Carolina Miranda-Castillo, Nina Khanna, Gustavo-Adolfo Méndez, Verena Petzer, Jan Novák, Caroline Besson, Rémy Duléry, Sylvain Lamure, Marcio Nucci, Giovanni Zambrotta, Pavel Žák, Guldane Cengiz Seval, Valentina Bonuomo, Jiří Mayer, Alberto López-García, Maria Vittoria Sacchi, Stephen Booth, Fabio Ciceri, Margherita Oberti, Marco Salvini, Macarena Izuzquiza, Raquel Nunes-Rodrigues, Emanuele Ammatuna, Aleš Obr, Raoul Herbrecht, Lucía Núñez-Martín-Buitrago, Valentina Mancini, Hawraa Shwaylia, Mariarita Sciumè, Jenna Essame, Marietta Nygaard, Josip Batinić, Yung Gonzaga, Isabel Regalado-Artamendi, Linda Katharina Karlsson, Maryia Shapetska, Michaela Hanakova, Shaimaa El-Ashwah, Zita Borbényi, Gökçe Melis Çolak, Anna Nordlander, Giulia Dragonetti, Alessio Maria Edoardo Maraglino, Amelia Rinaldi, Cristina De Ramón-Sánchez, Oliver A. Cornely, Olimpia Finizio, Rita Fazzi, Giuseppe Sapienza, Adrien Chauchet, Jens Van Praet, Juergen Prattes, Michelina Dargenio, Cédric Rossi, Ayten Shirinova, Sandra Malak, Agostino Tafuri, Hans-Beier Ommen, Serge Bologna, Reham Abdelaziz Khedr, Sylvain Choquet, Bertrand Joly, M. Mansour Ceesay, Laure Philippe, Chi Shan Kho, Maximilian Desole, Panagiotis Tsirigotis, Vladimir Otašević, Davimar M. M. Borducchi, Anastasia Antoniadou, Javid Gaziev, Muna A. Almaslamani, Nicole García-Poutón, Giovangiacinto Paterno, Andrea Torres-López, Giuseppe Tarantini, Sibylle Mellinghoff, Stefanie Gräfe, Niklas Börschel, Jakob Passweg, Maria Merelli, Aleksandra Barać, Dominik Wolf, Mohammad Usman Shaikh, Catherine Thiéblemont, Sophie Bernard, Vaneuza Araújo Moreira Funke, Etienne Daguindau, Sofya Khostelidi, Fabio Moore Nucci, Juan-Alberto Martín-González, Marianne Landau, Carole Soussain, Cécile Laureana, Karine Lacombe, Milena Kohn, Gunay Aliyeva, Monica Piedimonte, Guillemette Fouquet, Mayara Rêgo, Baerbel Hoell-Neugebauer, Guillaume Cartron, Fernando Pinto, Ana Munhoz Alburquerque, Juliana Passos, Asu Fergun Yilmaz, Ana-Margarita Redondo-Izal, Fevzi Altuntaş, Christopher Heath, Martin Kolditz, Enrico Schalk, Fabio Guolo, Meinolf Karthaus, Roberta Della Pepa, Donald Vinh, Nicolas Noël, Bénédicte Deau Fischer, Bernard Drenou, Maria Enza Mitra, Joseph Meletiadis, Yavuz M. Bilgin, Pavel Jindra, Ildefonso Espigado, Ľuboš Drgoňa, Alexandra Serris, Roberta Di Blasi, Natasha Ali
Journal: Journal of Hematology & Oncology (2021)

Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality. The survey was supported by the Scientific Working Group Infection in Hematology of the European Hematology Association (EHA). Eligible for the analysis were adult patients with HM and laboratory-confirmed COVID-19 observed between March and December 2020. The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma n = 1084, myeloma n = 684 and chronic lymphoid leukemia n = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia n = 497 and myelodysplastic syndromes n = 279). Severe/critical COVID-19 was observed in 63.8% of patients (n = 2425). Overall, 2778 (73.1%) of the patients were hospitalized, 689 (18.1%) of whom were admitted to intensive care units (ICUs). Overall, 1185 patients (31.2%) died. The primary cause of death was COVID-19 in 688 patients (58.1%), HM in 173 patients (14.6%), and a combination of both COVID-19 and progressing HM in 155 patients (13.1%). Highest mortality was observed in acute myeloid leukemia (199/497, 40%) and myelodysplastic syndromes (118/279, 42.3%). The mortality rate significantly decreased between the first COVID-19 wave (March-May 2020) and the second wave (October-December 2020) (581/1427, 40.7% vs. 439/1773, 24.8%, p value < 0.0001). In the multivariable analysis, age, active malignancy, chronic cardiac disease, liver disease, renal impairment, smoking history, and ICU stay correlated with mortality. Acute myeloid leukemia was a higher mortality risk than lymphoproliferative diseases. This survey confirms that COVID-19 patients with HM are at high risk of lethal complications. However, improved COVID-19 prevention has reduced mortality despite an increase in the number of reported cases.