gifsqph6

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?:abstract	BACKGROUND: Patients with cancer have been shown to have a higher risk of clinical severity and mortality compared to non-cancer patients with COVID-19. Patients with hematologic malignancies typically are known to have higher levels of immunosuppression and may develop more severe respiratory viral infections than patients with solid tumors. Data on COVID-19 in patients with hematologic malignancies are limited. Here we characterize disease severity and mortality and evaluate potential prognostic factors for mortality. METHODS: In this population-based registry study, we collected de-identified data on clinical characteristics, treatment and outcomes in adult patients with hematologic malignancies and confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection within the Madrid region of Spain. Our case series included all patients admitted to 22 regional health service hospitals and 5 private healthcare centers between February 28 and May 25, 2020. The primary study outcome was all-cause mortality. We assessed the association between mortality and potential prognostic factors using Cox regression analyses adjusted for age, sex, comorbidities, hematologic malignancy and recent active cancer therapy. RESULTS: Of 833 patients reported, 697 were included in the analyses. Median age was 72 years (IQR 60–79), 413 (60%) patients were male and 479 (69%) and 218 (31%) had lymphoid and myeloid malignancies, respectively. Clinical severity of COVID-19 was severe/critical in 429 (62%) patients. At data cutoff, 230 (33%) patients had died. Age ≥ 60 years (hazard ratios 3.17–10.1 vs < 50 years), > 2 comorbidities (1.41 vs ≤ 2), acute myeloid leukemia (2.22 vs non-Hodgkin lymphoma) and active antineoplastic treatment with monoclonal antibodies (2·02) were associated with increased mortality; conventional chemotherapy showed borderline significance (1.50 vs no active therapy). Conversely, Ph-negative myeloproliferative neoplasms (0.33) and active treatment with hypomethylating agents (0.47) were associated with lower mortality. Overall, 574 (82%) patients received antiviral therapy. Mortality with severe/critical COVID-19 was higher with no therapy vs any antiviral combination therapy (2.20). CONCLUSIONS: In this series of patients with hematologic malignancies and COVID-19, mortality was associated with higher age, more comorbidities, type of hematological malignancy and type of antineoplastic therapy. Further studies and long-term follow-up are required to validate these criteria for risk stratification.
?:creator	<https://research.tib.eu/covid-19/entity/Garc%C3%ADa-Su%C3%A1rez%2C_Julio%3B_de_la_Cruz%2C_Javier%3B_Cedillo%2C_%C3%81ngel%3B_Llamas%2C_Pilar%3B_Duarte%2C_Rafael%3B_Jim%C3%A9nez-Yuste%2C_V%C3%ADctor%3B_Hern%C3%A1ndez-Rivas%2C_Jos%C3%A9_%C3%81ngel%3B_Gil-Manso%2C_Rodrigo%3B_Kwon%2C_Mi%3B_S%C3%A1nchez-Godoy%2C_Pedro%3B_Mart%C3%ADnez-Barranco%2C_Pilar%3B_Col%C3%A1s-Lahuerta%2C_Blanca%3B_Herrera%2C_Pilar%3B_Benito-Parra%2C_Laurentino%3B_Alegre%2C_Adri%C3%A1n%3B_Velasco%2C_Alberto%3B_Matilla%2C_Arturo%3B_Al%C3%A1ez-Us%C3%B3n%2C_Mar%C3%ADa_Concepci%C3%B3n%3B_Martos-Mart%C3%ADnez%2C_Rafael%3B_Mart%C3%ADnez-Chamorro%2C_Carmen%3B_Susana-Quiroz%2C_Keina%3B_Del_Campo%2C_Juan_Francisco%3B_de_la_Fuente%2C_Adolfo%3B_Herr%C3%A1ez%2C_Regina%3B_Pascual%2C_Adriana%3B_G%C3%B3mez%2C_Elvira%3B_P%C3%A9rez-Oteyza%2C_Jaime%3B_Ruiz%2C_Elena%3B_Alonso%2C_Arancha%3B_Gonz%C3%A1lez-Medina%2C_Jos%C3%A9%3B_Mart%C3%ADn-Buitrago%2C_Luc%C3%ADa_N%C3%BA%C3%B1ez%3B_Canales%2C_Miguel%3B_Gonz%C3%A1lez-Gasc%C3%B3n%2C_Isabel%3B_Vicente-Ayuso%2C_Mar%C3%ADa_Carmen%3B_Valenciano%2C_Susana%3B_Roa%2C_Mar%C3%ADa_Garc%C3%ADa%3B_Monteliu%2C_Pablo_Estival%3B_L%C3%B3pez-Jim%C3%A9nez%2C_Javier%3B_Escobar%2C_Cristi%C3%A1n_Escolano%3B_Ortiz-Mart%C3%ADn%2C_Javier%3B_Diez-Martin%2C_Jos%C3%A9_Luis%3B_Martinez-Lopez%2C_Joaqu%C3%ADn>
?:doi	10.1186/s13045-020-00970-7
?:doi	<https://research.tib.eu/covid-19/entity/10.1186/s13045-020-00970-7>
?:journal	J_Hematol_Oncol
?:license	cc-by
?:pdf_json_files	document_parses/pdf_json/21bc72381784b06599a8fcfd2ccb9c018499bf61.json
?:pmc_json_files	document_parses/pmc_json/PMC7542567.xml.json
?:pmcid	<https://research.tib.eu/covid-19/entity/PMC7542567>
?:pmid	<https://research.tib.eu/covid-19/entity/33032660.0>
?:pmid	33032660.0
?:publication_isRelatedTo_Disease	<https://research.tib.eu/covid-19/entity/COVID-19>
?:sha_id	<https://research.tib.eu/covid-19/entity/21bc72381784b06599a8fcfd2ccb9c018499bf61>
?:source	Medline; PMC
?:title	Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study
?:type	<https://research.tib.eu/covid-19/vocab/Publication>
?:year	2020-10-08

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Value

?:abstract

BACKGROUND: Patients with cancer have been shown to have a higher risk of clinical severity and mortality compared to non-cancer patients with COVID-19. Patients with hematologic malignancies typically are known to have higher levels of immunosuppression and may develop more severe respiratory viral infections than patients with solid tumors. Data on COVID-19 in patients with hematologic malignancies are limited. Here we characterize disease severity and mortality and evaluate potential prognostic factors for mortality. METHODS: In this population-based registry study, we collected de-identified data on clinical characteristics, treatment and outcomes in adult patients with hematologic malignancies and confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection within the Madrid region of Spain. Our case series included all patients admitted to 22 regional health service hospitals and 5 private healthcare centers between February 28 and May 25, 2020. The primary study outcome was all-cause mortality. We assessed the association between mortality and potential prognostic factors using Cox regression analyses adjusted for age, sex, comorbidities, hematologic malignancy and recent active cancer therapy. RESULTS: Of 833 patients reported, 697 were included in the analyses. Median age was 72 years (IQR 60–79), 413 (60%) patients were male and 479 (69%) and 218 (31%) had lymphoid and myeloid malignancies, respectively. Clinical severity of COVID-19 was severe/critical in 429 (62%) patients. At data cutoff, 230 (33%) patients had died. Age ≥ 60 years (hazard ratios 3.17–10.1 vs < 50 years), > 2 comorbidities (1.41 vs ≤ 2), acute myeloid leukemia (2.22 vs non-Hodgkin lymphoma) and active antineoplastic treatment with monoclonal antibodies (2·02) were associated with increased mortality; conventional chemotherapy showed borderline significance (1.50 vs no active therapy). Conversely, Ph-negative myeloproliferative neoplasms (0.33) and active treatment with hypomethylating agents (0.47) were associated with lower mortality. Overall, 574 (82%) patients received antiviral therapy. Mortality with severe/critical COVID-19 was higher with no therapy vs any antiviral combination therapy (2.20). CONCLUSIONS: In this series of patients with hematologic malignancies and COVID-19, mortality was associated with higher age, more comorbidities, type of hematological malignancy and type of antineoplastic therapy. Further studies and long-term follow-up are required to validate these criteria for risk stratification.

?:creator