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Title: Risk factors and outcome of COVID-19 in patients with hematological malignancies
Author: Piñana, José Luis
Martino, Rodrigo
García García, Irene
Parody, Rocío
Morales, María Dolores
Benzo, Gonzalo
Gómez Catalan, Irene
Coll, Rosa
Fuente, Ignacio de la
Luna, Alejandro
Merchán, Beatriz
Chinea, Anabelle
Miguel, Dunia de
Serrano, Ana
Pérez, Carmen
Diaz, Carola
Lopez, José Luis
Saez, Adolfo Jesús
Bailen, Rebeca
Zudaire, Teresa
Martínez, Diana
Jurado, Manuel
Calbacho, María
Vázquez, Lourdes
Garcia Cadenas, Irene
Fox, Laura
Pimentel, Ana I.
Bautista, Guiomar
Nieto, Agustin
Fernandez, Pascual
Vallejo, Juan Carlos
Solano, Carlos
Valero, Marta
Espigado, Ildefonso
Saldaña, Raquel
Sisinni, Luisa
Ribera, Josep Maria
Jimenez, Maria Jose
Trabazo, Maria
Gonzalez Vicent, Marta
Fernández, Noemí
Talarn, Carme
Montoya, Maria Carmen
Cedillo, Angel
Sureda, Anna
Infectious Complications Subcommittee of the Spanish Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH)
Keywords: COVID-19
Factors de risc en les malalties
Malalties hematològiques
Pronòstic mèdic
Risk factors in diseases
Hematologic diseases
Issue Date: 25-Aug-2020
Publisher: BioMed Central
Abstract: Background: Prognostic factors of poor outcome in patients with hematological malignancies and COVID-19 are poorly defned. Patients and methods: This was a Spanish transplant group and cell therapy (GETH) multicenter retrospective observational study, which included a large cohort of blood cancer patients with laboratory-confrmed SARS-CoV-2 infection through PCR assays from March 1st 2020 to May 15th 2020. Results: We included 367 pediatric and adult patients with hematological malignancies, including recipients of autologous (ASCT) (n=58) or allogeneic stem cell transplantation (allo-SCT) (n=65) from 41 hospitals in Spain. Median age of patients was 64 years (range 1-93.8). Recipients of ASCT and allo-SCT showed lower mortality rates (17% and 18%, respectively) compared to non-SCT patients (31%) (p=0.02). Prognostic factors identifed for day 45 overall mortality (OM) by logistic regression multivariate analysis included age>70 years [odds ratio (OR) 2.1, 95% con‑ fdence interval (CI) 1.2-3.8, p=0.011]; uncontrolled hematological malignancy (OR 2.9, 95% CI 1.6-5.2, p<0.0001); ECOG 3-4 (OR, 2.56, 95% CI 1.4-4.7, p=0.003); neutropenia (<0.5×109 /L) (OR 2.8, 95% CI 1.3-6.1, p=0.01); and a C-reactive protein (CRP)>20 mg/dL (OR 3.3, 95% CI 1.7-6.4, p<0.0001). In multivariate analysis of 216 patients with very severe COVID-19, treatment with azithromycin or low dose corticosteroids was associated with lower OM (OR 0.42, 95% CI 0.2-0.89 and OR 0.31, 95% CI 0.11-0.87, respectively, p=0.02) whereas the use of hidroxycloroquine did not show signifcant improvement in OM (OR 0.64, 95% CI 0.37-1.1, P=0.1). Conclusions: In most patients with hematological malignancies COVID-19 mortality was directly driven by older age, disease status, performance status, as well as by immune (neutropenia) parameters and level of infammation (high CRP). Use of azithromycin and low dose corticosteroids may be of value in very severe COVID-19.
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It is part of: Experimental Hematology & Oncology, 2020, vol. 9, num. 21
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ISSN: 2162-3619
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (Ciències Clíniques)

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