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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/174432
Risk factors and outcome of COVID-19 in patients with hematological malignancies
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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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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). Risk factors and outcome of COVID-19 in patients with hematological malignancies. _Experimental Hematology & Oncology_. 2020. Vol. 9, núm. 21. [consulta: 24 de gener de 2026]. ISSN: 2162-3619. [Disponible a: https://hdl.handle.net/2445/174432]