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Clinical Characteristics and Outcome of COVID-19 in Turkish Hematological Malignancy Patients

Çivriz Bozdağ et al., Turk. J. Haematol., doi:10.4274/tjh.galenos.2021.2021.0287
Sep 2021  
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Mortality -399% Improvement Relative Risk HCQ for COVID-19  Çivriz Bozdağ et al.  LATE TREATMENT Is late treatment with HCQ beneficial for COVID-19? Retrospective 175 patients in Turkey Higher mortality with HCQ (p=0.003) c19hcq.org Çivriz Bozdağ et al., Turk. J. Haematol., Sep 2021 FavorsHCQ Favorscontrol 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 419 studies, recognized in 46 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19hcq.org
Retrospective 340 patients with hematological malignancy in Turkey, showing higher mortality with HCQ treatment. Confounding by time is likely because more HCQ patients were earlier in time when overall treatment protocols were significantly worse.
This study is excluded in the after exclusion results of meta analysis: substantial confounding by time likely due to declining usage over the early stages of the pandemic when overall treatment protocols improved dramatically.
risk of death, 399.2% higher, RR 4.99, p = 0.003, treatment 35, control 140.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Çivriz Bozdağ et al., 15 Sep 2021, retrospective, Turkey, peer-reviewed, 64 authors.
This PaperHCQAll
Clinical Characteristics and Outcomes of COVID-19 in Turkish Patients with Hematological Malignancies
Sinem Civriz Bozdağ, Güldane Cengiz Seval, İpek Yönal Hindilerden, Fehmi Hindilerden, Neslihan Andıç, Mustafa Baydar, Lale Aydın Kaynar, Selami Koçak Toprak, Hasan Sami Göksoy, Berrin Balık Aydın, Ufuk Demirci, Ferda Can, Vildan Özkocaman, Eren Gündüz, Zeynep Tuğba Güven, Zübeyde Nur Özkurt, Sinan Demircioğlu, Meral Beksaç, İdris İnce, Umut Yılmaz, Hilal Eroğlu Küçükdiler, Elgün Abishov, Boran Yavuz, Ünal Ataş, Yaşa Gül Mutlu, Volkan Baş, Fahir Özkalemkaş, Hava Üsküdar Teke, Vildan Gürsoy, Serhat Çelik, Rafiye Çiftçiler, Münci Yağcı, Pervin Topçuoğlu, Özcan Çeneli, Hamza Abbasov, Cem Selim, Muhlis Cem Ar, Orhan Kemal Yücel, Sevil Sadri, Canan Albayrak, Ahmet Muzaffer Demir, Nil Güler, Muzaffer Keklik, Hatice Terzi, Ali Doğan, Zeynep Arzu Yegin, Meltem Kurt Yüksel, Soğol Sadri, İrfan Yavaşoğlu, Hüseyin Saffet Beköz, Tekin Aksu, Senem Maral, Veysel Erol, Leylagül Kaynar, Osman İlhan, Ali Zahit Bolaman, Ömür Gökmen Sevindik, Arzu Akyay, Muhit Özcan, Günhan Gürman, Şule Ünal Cangül, Yasemin Yavuz, Reyhan Diz Küçükkaya, Güner Hayri Özsan
Turkish Journal of Hematology, doi:10.4274/tjh.galenos.2021.2021.0287
Patients with solid malignancies are more vulnerable to SARS-CoV-2 infection than healthy population. The outcome of SARS-CoV-2 infection in highly immunosupressed populations, such as in patients with hematological malignancies is a point of interest.We aimed to analyze the symptoms, complications, intensive care unit (ICU) admission and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. In this multicenter study, we included 340 adult and pediatric patients diagnosed as COVID-19 from March to November. Forty four (12.9%) patients were asymptomatic at diagnosis. In symptomatic patients, fever, cough and dyspnea were observed in 62.6%, 48.8 % and 41.8% of the patients, respectively. Sixty nine (20%) patients had mild SARS-Cov-2 disease, whereas moderate, severe and critical diseases were reported in 101 (29%), 71 (20%) and 55 (16%) patients, respectively. Two hundered fifty one (73.8%) patients were hospitalized for SARS-Cov2. Mortality related to SARS-CoV-2 infection was 26.5% in all cohort; 4.4% in those patients with mild disease, 12.4% in moderate disease and 83% in severe and critical disease. Active hematological disease, lower life expectancy related with primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission and firstline therapy used for COVID 19 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azitromycin were associated with a higher rate of mortality in comparison with favipiravir use.In conclusion, patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.
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García-Suárez J, de la Cruz J, Cedillo Á, Llamas P, Duarte R, ' 'Jiménez-Yuste V, Hernández-Rivas JÁ, Gil-Manso R, Kwon M, Sánchez-Godoy ' 'P, Martínez-Barranco P, Colás-Lahuerta B, Herrera P, Benito-Parra L, ' 'Alegre A, Velasco A, Matilla A, Aláez-Usón MC, Martos-Martínez R, ' 'Martínez-Chamorro C, Susana-Quiroz K, Del Campo JF, de la Fuente A, ' 'Herráez R, Pascual A, Gómez E, Pérez-Oteyza J, Ruiz E, Alonso A, ' 'González-Medina J, Martín-Buitrago LN, Canales M, González-Gascón I, ' 'Vicente-Ayuso MC, Valenciano S, Roa MG, Monteliu PE, López-Jiménez J, ' 'Escobar CE, Ortiz-Martín J, Diez-Martin JL, Martinez-Lopez J; Asociación ' 'Madrileña de Hematología y Hemoterapia (AMHH). Impact of hematological ' 'malignancy and type of cancer therapy on COVID-19 severity and ' 'mortality: lessons from a large population based registry study. J ' 'Hematol Oncol 2020;13:133.', 'journal-title': 'J Hematol Oncol'}, { 'key': 'ref17', 'doi-asserted-by': 'publisher', 'first-page': '2881', 'DOI': '10.1182/blood.2020008824', 'article-title': 'Outcomes of patients with hematologic malignancies and COVID-19: a ' 'systematic review and meta-analysis of 3377 patients', 'volume': '136', 'author': 'Vijenthira', 'year': '2020', 'unstructured': '17. Vijenthira A, Gong IY, Fox TA, Booth S, Cook G, Fattizzo B, Martin ' 'Moro F, Razanamahery J, Riches JC, Zwicker JI, Patell R, Vekemans MM, ' 'Scarfo L, Chatzikonstantinou T, Yildiz H, Lattenist R, Mantzaris I, Wood ' 'WA, Hicks LK. Outcomes of patients with hematologic malignancies and ' 'COVID-19: a systematic review and meta-analysis of 3377 patients. 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" 'COVID-19 outcomes in patients with hematologic disease. Bone Marrow ' 'Transplant 2020;55:2180-2184.', 'journal-title': 'Bone Marrow Transplant'}, { 'key': 'ref20', 'doi-asserted-by': 'publisher', 'unstructured': '20. Martín-Moro F, Marquet J, Piris M, Michael BM, Sáez AJ, Corona M, ' 'Jiménez C, Astibia B, García I, Rodríguez E, García-Hoz C, Fortún-Abete ' 'J, Herrera P, López-Jiménez J. Survival study of hospitalised patients ' 'with concurrent COVID-19 and haematological malignancies. Br J Haematol ' '2020;190:e16-e20.', 'DOI': '10.1111/bjh.16801'}, { 'key': 'ref21', 'doi-asserted-by': 'publisher', 'first-page': '3033', 'DOI': '10.1182/blood.2020008150', 'article-title': 'Clinical features associated with COVID-19 outcome in MM: first results ' 'from International Myeloma Society Dataset', 'volume': '36', 'author': 'Chari', 'year': '2020', 'unstructured': '21. Chari A, Samur MK, Martinez-Lopez J, Cook G, Biran N, Yong KL, ' 'Hungria VTM, Engelhardt M, Gay F, Garcia-Feria A, Oliva S, Oostvogels R, ' 'Gozzetti A, Rosenbaum CA, Kumar SK, Stadtmauer E, Einsele H, Beksac M, ' 'Weisel KC, Anderson KC, Mateos MV, Moreau P, San Miguel J, Munshi NC, ' 'Avet-Loiseau H. Clinical features associated with COVID-19 outcome in ' 'MM: first results from International Myeloma Society Dataset. Blood ' '2020;36:3033-3040.', 'journal-title': 'Blood'}, { 'key': 'ref22', 'doi-asserted-by': 'publisher', 'first-page': '2000', 'DOI': '10.1038/s41375-020-0876-z', 'article-title': 'Management of patients with multiple myeloma in the era of COVID-19 ' 'pandemic: a consensus paper from the European Myeloma Network (EMN)', 'volume': '34', 'author': 'Terpos', 'year': '2020', 'unstructured': '22. Terpos E, Engelhardt M, Cook G, Gay F, Mateos MV, ' 'Ntanasis-Stathopoulos I, van de Donk NWCJ, Avet-Loiseau H, Hajek R, ' 'Vangsted AJ, Ludwig H, Zweegman S, Moreau P, Einsele H, Boccadoro M, San ' 'Miguel J, Dimopoulos MA, Sonneveld P. Management of patients with ' 'multiple myeloma in the era of COVID-19 pandemic: a consensus paper from ' 'the European Myeloma Network (EMN). Leukemia 2020;34:2000-2011.', 'journal-title': 'Leukemia'}, { 'key': 'ref23', 'doi-asserted-by': 'publisher', 'first-page': '2254', 'DOI': '10.1038/s41375-020-0925-7', 'article-title': 'Impact of Covid-19 on the treatment of acute myeloid leukemia', 'volume': '34', 'author': 'Ferrara', 'year': '2020', 'unstructured': '23. Ferrara F, Zappasodi P, Roncoroni E, Borlenghi E, Rossi G. Impact of ' 'Covid-19 on the treatment of acute myeloid leukemia. Leukemia ' '2020;34:2254-2256.', 'journal-title': 'Leukemia'}, { 'key': 'ref24', 'doi-asserted-by': 'publisher', 'first-page': '2193', 'DOI': '10.1038/s41409-020-0913-6', 'article-title': 'COVID-19 pandemic and impact on hematopoietic stem cell transplantation', 'volume': '55', 'author': 'Sahu', 'year': '2020', 'unstructured': '24. Sahu KK, Siddiqui AD, Cerny J. COVID-19 pandemic and impact on ' 'hematopoietic stem cell transplantation. Bone Marrow Transplant ' '2020;55:2193-2195.', 'journal-title': 'Bone Marrow Transplant'}, { 'key': 'ref25', 'doi-asserted-by': 'publisher', 'first-page': '2030', 'DOI': '10.1056/NEJMoa2022926', 'article-title': 'Effect of hydroxychloroquine in hospitalized patients with Covid-19', 'volume': '383', 'author': 'Collaborative Group', 'year': '2020', 'unstructured': '25. RECOVERY Collaborative Group, Horby P, Mafham M, Linsell L, Bell JL, ' 'Staplin N, Emberson JR, Wiselka M, Ustianowski A, Elmahi E, Prudon B, ' 'Whitehouse T, Felton T, Williams J, Faccenda J, Underwood J, Baillie JK, ' 'Chappell LC, Faust SN, Jaki T, Jeffery K, Lim WS, Montgomery A, Rowan K, ' 'Tarning J, Watson JA, White NJ, Juszczak E, Haynes R, Landray MJ. Effect ' 'of hydroxychloroquine in hospitalized patients with Covid-19. N Engl J ' 'Med 2020;383:2030-2040.', 'journal-title': 'N Engl J Med'}, { 'key': 'ref26', 'doi-asserted-by': 'publisher', 'first-page': '2041', 'DOI': '10.1056/NEJMoa2019014', 'article-title': 'Hydroxychloroquine with or without azithromycin in mild-to-moderate ' 'Covid-19', 'volume': '383', 'author': 'AB', 'year': '2020', 'unstructured': '26. Cavalcanti AB, Zampieri FG, Rosa RG, Azevedo LCP, Veiga VC, Avezum ' 'A, Damiani LP, Marcadenti A, Kawano-Dourado L, Lisboa T, Junqueira DLM, ' 'de Barros E Silva PGM, Tramujas L, Abreu-Silva EO, Laranjeira LN, Soares ' 'AT, Echenique LS, Pereira AJ, Freitas FGR, Gebara OCE, Dantas VCS, ' 'Furtado RHM, Milan EP, Golin NA, Cardoso FF, Maia IS, Hoffmann Filho CR, ' 'Kormann APM, Amazonas RB, Bocchi de Oliveira MF, Serpa-Neto A, Falavigna ' 'M, Lopes RD, Machado FR, Berwanger O; Coalition Covid-19 Brazil I ' 'Investigators. Hydroxychloroquine with or without azithromycin in ' 'mild-to-moderate Covid-19. N Engl J Med 2020;383:2041-2052.', 'journal-title': 'N Engl J Med'}, { 'key': 'ref27', 'doi-asserted-by': 'publisher', 'first-page': '517', 'DOI': '10.1056/NEJMoa2016638', 'article-title': 'A randomized trial of hydroxychloroquine as postexposure prophylaxis ' 'for Covid-19', 'volume': '383', 'author': 'Boulware', 'year': '2020', 'unstructured': '27. Boulware DR, Pullen MF, Bangdiwala AS, Pastick KA, Lofgren SM, ' 'Okafor EC, Skipper CP, Nascene AA, Nicol MR, Abassi M, Engen NW, Cheng ' 'MP, LaBar D, Lother SA, MacKenzie LJ, Drobot G, Marten N, Zarychanski R, ' 'Kelly LE, Schwartz IS, McDonald EG, Rajasingham R, Lee TC, Hullsiek KH. ' 'A randomized trial of hydroxychloroquine as postexposure prophylaxis for ' 'Covid-19. N Engl J Med 2020;383:517-525.', 'journal-title': 'N Engl J Med'}, { 'key': 'ref28', 'doi-asserted-by': 'publisher', 'unstructured': '28. Coomes EA, Haghbayan H. Favipiravir, an antiviral for COVID-19? J ' 'Antimicrob Chemother 2020;75:2013-2014.', 'DOI': '10.1093/jac/dkaa171'}, { 'key': 'ref29', 'doi-asserted-by': 'publisher', 'first-page': '501', 'DOI': '10.1016/j.ijid.2020.10.069', 'article-title': 'Role of favipiravir in the treat-ment of COVID-19', 'volume': '102', 'author': 'Joshi', 'year': '2021', 'unstructured': '29. Joshi S, Parkar J, Ansari A, Vora A, Talwar D, Tiwaskar M, Patil S, ' 'Barkate H. Role of favipiravir in the treat-ment of COVID-19. Int J ' 'Infect Dis 2021;102:501-508.', 'journal-title': 'Int J Infect Dis'}], 'container-title': 'Turkish Journal of Hematology', 'original-title': [], 'deposited': { 'date-parts': [[2022, 6, 9]], 'date-time': '2022-06-09T07:31:29Z', 'timestamp': 1654759889000}, 'score': 1, 'resource': { 'primary': { 'URL': 'https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tjh&plng=eng&un=TJH-22697'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2022, 2, 24]]}, 'references-count': 30, 'journal-issue': {'issue': '1', 'published-online': {'date-parts': [[2022, 2, 24]]}}, 'URL': 'http://dx.doi.org/10.4274/tjh.galenos.2021.2021.0287', 'relation': {}, 'ISSN': ['1300-7777', '1308-5263'], 'subject': ['Hematology'], 'container-title-short': 'Tjh', 'published': {'date-parts': [[2022, 2, 24]]}}
Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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