Age, successive waves, immunization, and mortality in elderly COVID-19 hematological patients: EPICOVIDEHA findings
Giuseppe Rossi, Jon Salmanton‐García, Chiara Cattaneo, Francesco Marchesi, Julio Dávila, Sonia Martín‐Pérez, Federico Itri, Alberto López‐García, Andreas Glenthøj, María Gomes da Silva, Caroline Besson, Monia Marchetti, Barbora Weinbergerová, Ozren Jakšić, Moraima Jiménez, Yavuz M. Bilgin, Jaap A. van Doesum, Francesca Farina, Павел Зак, Luisa Verga, Graham P. Collins, Valentina Bonuomo, Jens Van Praet, Márcio Nucci, Stef Meers, Ildefonso Espigado, Nicola Stefano Fracchiolla, Toni Valković, Christian Bjørn Poulsen, Natasha Čolović, Giulia Dragonetti, Marie‐Pierre Ledoux, Carlo Tascini, Caterina Buquicchio, Ola Blennow, Francesco Passamonti, Marina Machado, Jorge Labrador, Rafael F. Duarte, Martin Schönlein, Lucia Prezioso, Iker Falces‐Romero, Austin Kulasekararaj, Carolina García‐Vidal, Noemí Fernández, Ghaith Abu‐Zeinah, Irati Ormazabal‐Vélez, Tatjana Adžić‐Vukičević, Klára Piukovics, И. О. Стома, Annarosa Cuccaro, Gabriele Magliano, Tomáš Szotkowski, Tomás José González‐López, Shaimaa El‐Ashwah, Rui Bergantim, Uluhan Sili, Johan Maertens, Fatih Demırkan, Cristina De Ramón, Verena Petzer, Maria Ilaria Del Principe, Milan Navrátil, Michelina Dargenio, Güldane Cengiz Seval, Michail Samarkos, Zdeněk Ráčil, László Imre Pinczés, Tobias Lahmer, Alessandro Busca, Gustavo‐Adolfo Méndez, Antonio Vena, Monika Biernat, Maria Merelli, María Calbacho, Aleksandra Barać, Martina Bavastro, Alessandro Limongelli, Osman İlhan, Dominik Wolf, Gökçe Melis Çolak, Ramón García‐Sánz, Ziad Emarah, Bojana Mišković, Stefanie K. Gräfe, Miloš Mladenović, Tommaso Francesco Aiello, Lucía Núñez-Martín-Buitrago, Anna Nordlander, Elena Arellano, Giovanni Paolo Maria Zambrotta, Emanuele Ammatuna, Alba Cabirta, Maria Vittoria Sacchi, Raquel Nunes Rodrigues, Ditte Stampe Hersby, Michaela Hanáková, Laman Rahimli, Raúl Córdoba, Oliver A. Cornely
Abstract
OBJECTIVES: Elderly patients with hematologic malignancies face the highest risk of severe COVID-19 outcomes. The infection's impact on different age groups remains unstudied in detail. METHODS: We analyzed elderly patients (age groups: 65-70, 71-75, 76-80, and >80 years old) with hematologic malignancies included in the EPICOVIDEHA registry between January 2020 and July 2022. Univariable and multivariable Cox regression models were conducted to identify factors influencing death in COVID-19 patients with hematological malignancy. RESULTS: The study included data from 3,603 elderly patients (aged 65 or older) with hematological malignancy, with a majority being male (58.1%) and a significant proportion having comorbidities. The patients were divided into four age groups, and the analysis assessed COVID-19 outcomes, vaccination status, and other variables in relation to age and pandemic waves. The 90-day survival rate for patients with COVID-19 was 71.2%, with significant differences between groups. The pandemic waves had varying impacts, with the first wave affecting patients over 80 years old, the second being more severe in 65-70, and the third being the least severe in all age groups. Factors contributing to 90-day mortality included age, comorbidities, lymphopenia, active malignancy, acute leukemia, less than three vaccine doses, severe COVID-19, and using only corticosteroids as treatment. CONCLUSION: These data underscore the heterogeneity of elderly hematological patients, highlight the different impacts of COVID-19 waves and the pivotal importance of vaccination, and may help in planning future healthcare efforts.