A prognostic model for patients with lymphoma and COVID-19: a multicentre cohort study
Carlo Visco, Luigi Marcheselli, Roberto Mina, Marianna Sassone, Anna Guidetti, Domenico Penna, Chiara Cattaneo, Valentina Bonuomo, Alessandro Busca, Andrés J.M. Ferreri, Riccardo Bruna, Luigi Petrucci, Roberto Cairoli, Marco Salvini, Lorenza Bertù, Marco Ladetto, Sofia Pilerci, Antonio Pinto, Safaa Ramadan, Francesco Marchesi, Michèle Cavo, Luca Arcaini, Elisa Coviello, Alessandra Romano, Pellegrino Musto, Massimo Massaia, Nicola Stefano Fracchiolla, Monia Marchetti, Annamaria Scattolin, Maria Chiara Tisi, Antonio Cuneo, Matteo Giovanni Della Porta, Livio Trentin, Marco Turrini, Filíppo Gherlinzoni, Agostino Tafuri, Sara Galimberti, Monica Bocchia, Valeria Cardinali, Daniela Cilloni, Alessandro Corso, Daniele Armiento, Luigi Rigacci, Elettra Ortu La Barbera, Carlo Gambacorti‐Passerini, Giuseppe Visani, Daniele Vallisa, Adriano Venditti, Carmine Selleri, Annarita Conconi, Patrizia Tosi, Francesco Lanza, Anna Candoni, Mauro Krampera, Paolo Corradini, Francesco Passamonti, Francesco Merli, on behalf of the ITA-HEMA-COV investigators
Abstract
Lymphoma represents a heterogeneous hematological malignancy (HM), which is characterized by severe immunosuppression. Patients diagnosed of coronavirus disease 2019 (COVID-19) during the course of HM have been described to have poor outcome, with only few reports specifically addressing lymphoma patients. Here, we investigated the clinical behavior and clinical parameters of a large multicenter cohort of adult patients with different lymphoma subtypes, with the aim of identifying predictors of death. The study included 856 patients, of whom 619 were enrolled prospectively in a 1-year frame and were followed-up for a median of 66 days (range 1-395). Patients were managed as outpatient (not-admitted cohort, n = 388) or required hospitalization (n = 468), and median age was 63 years (range 19-94). Overall, the 30- and 100-days mortality was 13% (95% confidence interval (CI), 11% to 15%) and 23% (95% CI, 20% to 27%), respectively. Antilymphoma treatment, including anti-CD20 containing regimens, did not impact survival. Patients with Hodgkin's lymphoma had the more favorable survival, but this was partly related to significantly younger age. The time interval between lymphoma diagnosis and COVID-19 was inversely related to mortality. Multivariable analysis recognized 4 easy-to-use factors (age, gender, lymphocyte, and platelet count) that were associated with risk of death, both in the admitted and in the not-admitted cohort (HR 3.79 and 8.85 for the intermediate- and high-risk group, respectively). Overall, our study shows that patients should not be deprived of the best available treatment of their underlying disease and indicates which patients are at higher risk of death. This study was registered with ClinicalTrials.gov, NCT04352556.