Higher mortality of hospitalized haematologic patients with COVID-19 compared to non-haematologic is driven by thrombotic complications and development of ARDS: An age-matched cohorts study
et al., Clinical Infection in Practice,
Retrospective 71 hospitalized haematologic patients in Spain, showing lower mortality with HCQ treatment in unadjusted results and without statistical significance.
Although the 27% lower mortality is not statistically significant, it is consistent with the significant 24% lower mortality [19‑28%]
from meta analysis of the 244 mortality results to date
This study is excluded in the after exclusion results of meta
unadjusted results with no group details.
risk of death, 27.0% lower, RR 0.73, p = 0.47, treatment 23 of 63 (36.5%), control 4 of 8 (50.0%), NNT 7.4.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Fernández-Cruz et al., 31 Jan 2022, retrospective, Spain, peer-reviewed, 10 authors, study period March 2020 - May 2020.
Abstract: Clinical Infection in Practice 13 (2022) 100137
Contents lists available at ScienceDirect
Clinical Infection in Practice
journal homepage: www.sciencedirect.com/journal/clinical-infection-in-practice
Case Reports and Series
Higher mortality of hospitalized haematologic patients with COVID-19
compared to non-haematologic is driven by thrombotic complications and
development of ARDS: An age-matched cohorts study☆
Ana Fernández-Cruz a, g, *, Alba Puyuelo b, Lucía Núñez Martín-Buitrago b, Enrique SánchezChica c, Carmen Díaz-Pedroche d, h, j, Rosa Ayala e, h, Manuel Lizasoain f, h, Rafael Duarte b, g, i,
Carlos Lumbreras f, h, j, Juan Antonio Vargas c, g, i
Infectious Diseases Department, Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
Haematology Department, Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
Internal Medicine Department, Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
Internal Medicine Department, Hospital Doce de Octubre, Madrid, Spain
Haematology Department, Hospital Doce de Octubre, Madrid, Spain
Infectious Diseases Department, Hospital Doce de Octubre, Madrid, Spain
Fundación de Investigación Sanitaria Puerta de Hierro - Segovia de Arana, Spain
Fundación para la Investigación Biomédica del Hospital Universitario, 12 de Octubre, Spain
Universidad Autónoma de Madrid, Spain
Universidad Complutense de Madrid, Spain
A R T I C L E I N F O
A B S T R A C T
Background and Objectives: The characteristics of COVID-19 in haematologic patients compared to nonhaematologic patients have seldom been analyzed. Our aim was to analyze whether there are differences in
clinical characteristics and outcome of haematologic patients with COVID-19 as compared to non-haematologic.
Patients and methods: Retrospective cohort study in 2 University hospitals of patients admitted with laboratoryconfirmed COVID-19 included in the SEMICOVID19 database. The cohort with underlying haematologic disease
was compared to a cohort of age and date-of-COVID-19-matched controls without haematologic disease (1:2).
Results: 71 cases and 142 controls were included from March-May 2020.
Twenty (28.1%) had received recent chemotherapy. Twelve (16.9%) were stem cell transplant recipients (SCT).
Eleven (15.5%) were neutropenic concurrently with COVID-19 diagnosis.
Haematologic patients presented ARDS (58.5 vs 20.7%, p = 0.0001), thrombotic complications (15.7 vs 2.1%, p
= 0.002), DIC (5.7 vs 0.0%, p = 0.011), heart failure (14.3 vs 4.9%, p = 0.029) and required ICU admission (15.5
vs 2.8%, p = 0.001), MV (14.1% vs 2.1%, p 0.001), steroid (64.8 vs 33.1%, p = 0.0001), tocilizumab (33.8 vs
8.5%, p = 0.0001) or anakinra treatment (9.9% vs 0%, p = 0.0001) more often. In-hospital mortality was
significantly higher (38.0% vs 18.3%, p = 0.002).
Conclusions: Our results suggest COVID-19 has worse outcomes in haematologic patients than in nonhaematologic, independently of age, and that the development of ARDS and thrombotic complications drive
the higher in-hospital mortality.
Abbreviations: ARDS, acute respiratory distress syndrome; C-RP, C-reactive protein; CI, confidence interval; CLL, chronic lymphocytic leukemia; COVID-19,
Coronavirus disease 2019; DIC, disseminated intravascular coagulation; ECOG scale, Eastern Cooperative Oncology Group scale; G-CSF, granulocyte stimulating
factor; HFNC, high flow nasal cannula; ICU, Intensive Care Unit; IL6, Interleukin 6; IQR,..
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