Clinical course and risk factors for mortality from COVID‐19 in patients with haematological malignancies
José María Sánchez‐Pina, Mario Rodríguez, Nerea Castro Quismondo, Rodrigo Gil Manso, Rafael Colmenares, Daniel Gil-Alós, Mari Liz Paciello, Denis Zafra, Cristina Garcia‐Sanchez, Carolina Villegas, Clara Cuéllar, Gonzalo Carreño‐Tarragona, Irene Zamanillo, María Poza, Rodrigo Íñiguez, Xabier Gutiérrez, Rafael Alonso, Antonia Rodríguez, María Dolores Folgueira, Rafaël Delgado, José Miguel Ferrari, Manuel Lizasoaín, José María Aguado, Rosa Ayala, Joaquín Martínez‐López, María Calbacho
Abstract
BACKGROUND: The impact of coronavirus disease 2019 (COVID-19) in haematological patients (HP) has not been comprehensively reported. METHODS: We analysed 39 patients with SARS-CoV-2 infection and haematological malignancies. Clinical characteristics and outcomes were compared to a matched control group of 53 non-cancer patients with COVID-19. Univariate and multivariate analyses were carried out to assess the risk factors associated with poor outcome. RESULTS: The most frequent haematological diseases were lymphoma (30%) and multiple myeloma (30%). Eighty-seven % HP developed moderate or severe disease. Patients with haematological malignancies had a significantly higher mortality rate compared to non-cancer patients (35.9% vs 13.2%; P = .003 (odds ratio 6.652). The worst outcome was observed in chronic lymphocytic leukaemia patients. Only age >70 years and C reactive protein >10 mg/dl at admission were associated with higher risk of death (odds ratio 34.86, P = .003 and 13.56,P = .03). Persistent viral sheddind was detected in 5 HP. Active chemotherapy, viral load at diagnosis and COVID-19 therapy were not predictors of outcome. CONCLUSION: Mortality of COVID-19 is significantly higher in patients with haematological malignancies compared to non-cancer patients. The impact of persistent viral shedding must be considered in order to re-start therapies and maintain infectious control measures.