COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA)

Background: Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality. Methods: The survey was supported by the Scientific Working Group Infection in Hematology of the European Hematology Association (EHA). Eligible for the analysis were adult patients with HM and laboratory-confirmed COVID-19 observed between March and December 2020. Results: The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma n = 1084, myeloma n = 684 and chronic lymphoid leukemia n = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia n = 497 and myelodysplastic syndromes n = 279). Severe/critical COVID-19 was observed in 63.8% of patients (n = 2425). Overall, 2778 (73.1%) of the patients were hospitalized, 689 (18.1%) of whom were admitted to intensive care units (ICUs). Overall, 1185 patients (31.2%) died. The primary cause of death was COVID-19 in 688 patients (58.1%), HM in 173 patients (14.6%), and a combination of both COVID-19 and progressing HM in 155 patients (13.1%). Highest mortality was observed in acute myeloid leukemia (199/497, 40%) and myelodysplastic syndromes (118/279, 42.3%). The mortality rate significantly decreased between the first COVID-19 wave (March–May 2020) and the second wave (October–December 2020) (581/1427, 40.7% vs. 439/1773, 24.8%, p value < 0.0001). In the multivariable analysis, age, active malignancy, chronic cardiac disease, liver disease, renal impairment, smoking history, and ICU stay correlated with mortality. Acute myeloid leukemia was a higher mortality risk than lymphoproliferative diseases. Conclusions: This survey confirms that COVID-19 patients with HM are at high risk of lethal complications. However, improved COVID-19 prevention has reduced mortality despite an increase in the number of reported cases.EPICOVIDEHA has received funds from Optics COMMITTM (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223)

COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA)

195sinoneBackground: Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality. Methods: The survey was supported by the Scientific Working Group Infection in Hematology of the European Hematology Association (EHA). Eligible for the analysis were adult patients with HM and laboratory-confirmed COVID-19 observed between March and December 2020. Results: The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma n = 1084, myeloma n = 684 and chronic lymphoid leukemia n = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia n = 497 and myelodysplastic syndromes n = 279). Severe/critical COVID-19 was observed in 63.8% of patients (n = 2425). Overall, 2778 (73.1%) of the patients were hospitalized, 689 (18.1%) of whom were admitted to intensive care units (ICUs). Overall, 1185 patients (31.2%) died. The primary cause of death was COVID-19 in 688 patients (58.1%), HM in 173 patients (14.6%), and a combination of both COVID-19 and progressing HM in 155 patients (13.1%). Highest mortality was observed in acute myeloid leukemia (199/497, 40%) and myelodysplastic syndromes (118/279, 42.3%). The mortality rate significantly decreased between the first COVID-19 wave (March–May 2020) and the second wave (October–December 2020) (581/1427, 40.7% vs. 439/1773, 24.8%, p value &lt; 0.0001). In the multivariable analysis, age, active malignancy, chronic cardiac disease, liver disease, renal impairment, smoking history, and ICU stay correlated with mortality. Acute myeloid leukemia was a higher mortality risk than lymphoproliferative diseases. Conclusions: This survey confirms that COVID-19 patients with HM are at high risk of lethal complications. However, improved COVID-19 prevention has reduced mortality despite an increase in the number of reported cases.nonePagano L.; Salmanton-Garcia J.; Marchesi F.; Busca A.; Corradini P.; Hoenigl M.; Klimko N.; Koehler P.; Pagliuca A.; Passamonti F.; Verga L.; Visek B.; Ilhan O.; Nadali G.; Weinbergerova B.; Cordoba-Mascunano R.; Marchetti M.; Collins G.P.; Farina F.; Cattaneo C.; Cabirta A.; Gomes-Silva M.; Itri F.; van Doesum J.; Ledoux M.-P.; Cernan M.; Jaksic O.; Duarte R.F.; Magliano G.; Omrani A.S.; Fracchiolla N.S.; Kulasekararaj A.; Valkovic T.; Poulsen C.B.; Machado M.; Glenthoj A.; Stoma I.; Racil Z.; Piukovics K.; Navratil M.; Emarah Z.; Sili U.; Maertens J.; Blennow O.; Bergantim R.; Garcia-Vidal C.; Prezioso L.; Guidetti A.; del Principe M.I.; Popova M.; de Jonge N.; Ormazabal-Velez I.; Fernandez N.; Falces-Romero I.; Cuccaro A.; Meers S.; Buquicchio C.; Antic D.; Al-Khabori M.; Garcia-Sanz R.; Biernat M.M.; Tisi M.C.; Sal E.; Rahimli L.; Colovic N.; Schonlein M.; Calbacho M.; Tascini C.; Miranda-Castillo C.; Khanna N.; Mendez G.-A.; Petzer V.; Novak J.; Besson C.; Dulery R.; Lamure S.; Nucci M.; Zambrotta G.; Zak P.; Seval G.C.; Bonuomo V.; Mayer J.; Lopez-Garcia A.; Sacchi M.V.; Booth S.; Ciceri F.; Oberti M.; Salvini M.; Izuzquiza M.; Nunes-Rodrigues R.; Ammatuna E.; Obr A.; Herbrecht R.; Nunez-Martin-Buitrago L.; Mancini V.; Shwaylia H.; Sciume M.; Essame J.; Nygaard M.; Batinic J.; Gonzaga Y.; Regalado-Artamendi I.; Karlsson L.K.; Shapetska M.; Hanakova M.; El-Ashwah S.; Borbenyi Z.; Colak G.M.; Nordlander A.; Dragonetti G.; Maraglino A.M.E.; Rinaldi A.; De Ramon-Sanchez C.; Cornely O.A.; Finizio O.; Fazzi R.; Sapienza G.; Chauchet A.; Van Praet J.; Prattes J.; Dargenio M.; Rossi C.; Shirinova A.; Malak S.; Tafuri A.; Ommen H.-B.; Bologna S.; Khedr R.A.; Choquet S.; Joly B.; Ceesay M.M.; Philippe L.; Kho C.S.; Desole M.; Tsirigotis P.; Otasevic V.; Borducchi D.M.M.; Antoniadou A.; Gaziev J.; Almaslamani M.A.; Garcia-Pouton N.; Paterno G.; Torres-Lopez A.; Tarantini G.; Mellinghoff S.; Grafe S.; Borschel N.; Passweg J.; Merelli M.; Barac A.; Wolf D.; Shaikh M.U.; Thieblemont C.; Bernard S.; Funke V.A.M.; Daguindau E.; Khostelidi S.; Nucci F.M.; Martin-Gonzalez J.-A.; Landau M.; Soussain C.; Laureana C.; Lacombe K.; Kohn M.; Aliyeva G.; Piedimonte M.; Fouquet G.; Rego M.; Hoell-Neugebauer B.; Cartron G.; Pinto F.; Alburquerque A.M.; Passos J.; Yilmaz A.F.; Redondo-Izal A.-M.; Altuntas F.; Heath C.; Kolditz M.; Schalk E.; Guolo F.; Karthaus M.; Della Pepa R.; Vinh D.; Noel N.; Deau Fischer B.; Drenou B.; Mitra M.E.; Meletiadis J.; Bilgin Y.M.; Jindra P.; Espigado I.; Drgona L.; Serris A.; Di Blasi R.; Ali N.Pagano, L.; Salmanton-Garcia, J.; Marchesi, F.; Busca, A.; Corradini, P.; Hoenigl, M.; Klimko, N.; Koehler, P.; Pagliuca, A.; Passamonti, F.; Verga, L.; Visek, B.; Ilhan, O.; Nadali, G.; Weinbergerova, B.; Cordoba-Mascunano, R.; Marchetti, M.; Collins, G. P.; Farina, F.; Cattaneo, C.; Cabirta, A.; Gomes-Silva, M.; Itri, F.; van Doesum, J.; Ledoux, M. -P.; Cernan, M.; Jaksic, O.; Duarte, R. F.; Magliano, G.; Omrani, A. S.; Fracchiolla, N. S.; Kulasekararaj, A.; Valkovic, T.; Poulsen, C. B.; Machado, M.; Glenthoj, A.; Stoma, I.; Racil, Z.; Piukovics, K.; Navratil, M.; Emarah, Z.; Sili, U.; Maertens, J.; Blennow, O.; Bergantim, R.; Garcia-Vidal, C.; Prezioso, L.; Guidetti, A.; del Principe, M. I.; Popova, M.; de Jonge, N.; Ormazabal-Velez, I.; Fernandez, N.; Falces-Romero, I.; Cuccaro, A.; Meers, S.; Buquicchio, C.; Antic, D.; Al-Khabori, M.; Garcia-Sanz, R.; Biernat, M. M.; Tisi, M. C.; Sal, E.; Rahimli, L.; Colovic, N.; Schonlein, M.; Calbacho, M.; Tascini, C.; Miranda-Castillo, C.; Khanna, N.; Mendez, G. -A.; Petzer, V.; Novak, J.; Besson, C.; Dulery, R.; Lamure, S.; Nucci, M.; Zambrotta, G.; Zak, P.; Seval, G. C.; Bonuomo, V.; Mayer, J.; Lopez-Garcia, A.; Sacchi, M. V.; Booth, S.; Ciceri, F.; Oberti, M.; Salvini, M.; Izuzquiza, M.; Nunes-Rodrigues, R.; Ammatuna, E.; Obr, A.; Herbrecht, R.; Nunez-Martin-Buitrago, L.; Mancini, V.; Shwaylia, H.; Sciume, M.; Essame, J.; Nygaard, M.; Batinic, J.; Gonzaga, Y.; Regalado-Artamendi, I.; Karlsson, L. K.; Shapetska, M.; Hanakova, M.; El-Ashwah, S.; Borbenyi, Z.; Colak, G. M.; Nordlander, A.; Dragonetti, G.; Maraglino, A. M. E.; Rinaldi, A.; De Ramon-Sanchez, C.; Cornely, O. A.; Finizio, O.; Fazzi, R.; Sapienza, G.; Chauchet, A.; Van Praet, J.; Prattes, J.; Dargenio, M.; Rossi, C.; Shirinova, A.; Malak, S.; Tafuri, A.; Ommen, H. -B.; Bologna, S.; Khedr, R. A.; Choquet, S.; Joly, B.; Ceesay, M. M.; Philippe, L.; Kho, C. S.; Desole, M.; Tsirigotis, P.; Otasevic, V.; Borducchi, D. M. M.; Antoniadou, A.; Gaziev, J.; Almaslamani, M. A.; Garcia-Pouton, N.; Paterno, G.; Torres-Lopez, A.; Tarantini, G.; Mellinghoff, S.; Grafe, S.; Borschel, N.; Passweg, J.; Merelli, M.; Barac, A.; Wolf, D.; Shaikh, M. U.; Thieblemont, C.; Bernard, S.; Funke, V. A. M.; Daguindau, E.; Khostelidi, S.; Nucci, F. M.; Martin-Gonzalez, J. -A.; Landau, M.; Soussain, C.; Laureana, C.; Lacombe, K.; Kohn, M.; Aliyeva, G.; Piedimonte, M.; Fouquet, G.; Rego, M.; Hoell-Neugebauer, B.; Cartron, G.; Pinto, F.; Alburquerque, A. M.; Passos, J.; Yilmaz, A. F.; Redondo-Izal, A. -M.; Altuntas, F.; Heath, C.; Kolditz, M.; Schalk, E.; Guolo, F.; Karthaus, M.; Della Pepa, R.; Vinh, D.; Noel, N.; Deau Fischer, B.; Drenou, B.; Mitra, M. E.; Meletiadis, J.; Bilgin, Y. M.; Jindra, P.; Espigado, I.; Drgona, L.; Serris, A.; Di Blasi, R.; Ali, N