The evolving landscape of <scp>COVID</scp>‐19 and <scp>post‐COVID</scp> condition in patients with chronic lymphocytic leukemia: A study by <scp>ERIC</scp>, the <scp>European</scp> research initiative on <scp>CLL</scp>
Andrea Visentin, Thomas Chatzikonstantinou, Lydia Scarfò, Anargyros Kapetanakis, Christos Demosthenous, Georgios Karakatsoulis, Eva Minga, Dimitra Chamou, David Allsup, Alejandro Alonso Cabrero, Martin Andres, Darko Antić, Mónica Baile, Panagiotis Baliakas, Sotiria Besikli‐Dimou, Dominique Bron, Sofia Chatzileontiadou, Raúl Córdoba, Juan Gonzalo Correa, Carolina Cuéllar‐García, Lorenzo De Paoli, Maria Rosaria De Paolis, Julio Delgado, Maria Dimou, David Donaldson, Mark Catherwood, Michael Doubek, Maria Efstathopoulou, Barbara Eichhorst, Salma Elashwah, Alicia Enrico, Blanca Espinet, Lucia Farina, Angela Ferrari, Myriam Foglietta, Henrik Frederiksen, Moritz Fürstenau, José A. García‐Marco, Rocío García‐Serra, Rosa Collado, Massimo Gentile, Eva Gimeno, Andreas Glenthøj, María Gomes da Silva, Yervand Hakobyan, Yair Herishanu, José‐Ángel Hernández‐Rivas, Tobias Herold, Idanna Innocenti, Gilad Itchaki, Ozren Jakšić, Ann Janssens, Olga Kalashnikova, Elżbieta Kalicińska, Arnon P. Kater, Sabina Kersting, Jorge Labrador, Deepesh Lad, Luca Laurenti, Mark‐David Levin, Enrico Lista, Alberto López‐García, Lara Malerba, Roberto Marasca, Monia Marchetti, Juan Marquet, Mattias Mattsson, Francesca Romana Mauro, Marta Morawska, Marina Motta, Talha Munir, Roberta Murru, Carsten Utoft Niemann, Raquel Nunes Rodrigues, Jacopo Olivieri, Lorella Orsucci, Maria Papaioannou, Miguel Arturo Pavlovsky, Inga Piskunova, Viola Maria Popov, Francesca Maria Quaglia, Giulia Quaresmini, Kristian Qvist, Gian Matteo Rigolin, Rosa Ruchlemer, Martin Šimkovič, Martin Špaček, Paolo Sportoletti, Oana Stanca, Tamar Tadmor, Antonella Capasso, Giovanni Del Poeta, Odit Gutwein, Linda Karlsson, Ivana Milošević, Fátima Mirás, Gianluigi Reda, Gevorg Saghumyan, Amit Shrestha, Doreen te Raa
Abstract
In this retrospective international multicenter study, we describe the clinical characteristics and outcomes of patients with chronic lymphocytic leukemia (CLL) and related disorders (small lymphocytic lymphoma and high-count monoclonal B lymphocytosis) infected by SARS-CoV-2, including the development of post-COVID condition. Data from 1540 patients with CLL infected by SARS-CoV-2 from January 2020 to May 2022 were included in the analysis and assigned to four phases based on cases disposition and SARS-CoV-2 variants emergence. Post-COVID condition was defined according to the WHO criteria. Patients infected during the most recent phases of the pandemic, though carrying a higher comorbidity burden, were less often hospitalized, rarely needed intensive care unit admission, or died compared to patients infected during the initial phases. The 4-month overall survival (OS) improved through the phases, from 68% to 83%, p = .0015. Age, comorbidity, CLL-directed treatment, but not vaccination status, emerged as risk factors for mortality. Among survivors, 6.65% patients had a reinfection, usually milder than the initial one, and 16.5% developed post-COVID condition. The latter was characterized by fatigue, dyspnea, lasting cough, and impaired concentration. Infection severity was the only risk factor for developing post-COVID. The median time to resolution of the post-COVID condition was 4.7 months. OS in patients with CLL improved during the different phases of the pandemic, likely due to the improvement of prophylactic and therapeutic measures against SARS-CoV-2 as well as the emergence of milder variants. However, mortality remained relevant and a significant number of patients developed post-COVID conditions, warranting further investigations.