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
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
analysis:
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.
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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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Fernández-Cruz et al., 31 Jan 2022, retrospective, Spain, peer-reviewed, 10 authors, study period March 2020 - May 2020.
Contact:
afcruz@salud.madrid.org.
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
a
Infectious Diseases Department, Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
Haematology Department, Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
c
Internal Medicine Department, Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
d
Internal Medicine Department, Hospital Doce de Octubre, Madrid, Spain
e
Haematology Department, Hospital Doce de Octubre, Madrid, Spain
f
Infectious Diseases Department, Hospital Doce de Octubre, Madrid, Spain
g
Fundación de Investigación Sanitaria Puerta de Hierro - Segovia de Arana, Spain
h
Fundación para la Investigación Biomédica del Hospital Universitario, 12 de Octubre, Spain
i
Universidad Autónoma de Madrid, Spain
j
Universidad Complutense de Madrid, Spain
b
A R T I C L E I N F O
A B S T R A C T
Keywords
COVID-19
Haematologic
Outcome
Mortality
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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