Risk factors and outcome of COVID-19 in patients with hematological malignancies

{ 'indexed': {'date-parts': [[2024, 2, 23]], 'date-time': '2024-02-23T14:26:50Z', 'timestamp': 1708698410748}, 'reference-count': 47, 'publisher': 'Springer Science and Business Media LLC', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2020, 8, 25]], 'date-time': '2020-08-25T00:00:00Z', 'timestamp': 1598313600000}, 'content-version': 'tdm', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}, { 'start': { 'date-parts': [[2020, 8, 25]], 'date-time': '2020-08-25T00:00:00Z', 'timestamp': 1598313600000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0'}], 'content-domain': {'domain': ['link.springer.com'], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2020, 12]]}, 'abstract': '<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Prognostic ' 'factors of poor outcome in patients with hematological malignancies and COVID-19 are poorly ' 'defined.</jats:p></jats:sec><jats:sec><jats:title>Patients and ' 'methods</jats:title><jats:p>This was a Spanish transplant group and cell therapy (GETH) ' 'multicenter retrospective observational study, which included a large cohort of blood cancer ' 'patients with laboratory-confirmed SARS-CoV-2 infection through PCR assays from March 1st ' '2020 to May 15th ' '2020.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We included 367 ' 'pediatric and adult patients with hematological malignancies, including recipients of ' 'autologous (ASCT) (n\u2009=\u200958) or allogeneic stem cell transplantation (allo-SCT) ' '(n\u2009=\u200965) from 41 hospitals in Spain. Median age of patients was 64\xa0years (range ' '1–93.8). Recipients of ASCT and allo-SCT showed lower mortality rates (17% and 18%, ' 'respectively) compared to non-SCT patients (31%) (p\u2009=\u20090.02). Prognostic factors ' 'identified for day 45 overall mortality (OM) by logistic regression multivariate analysis ' 'included age\u2009&gt;\u200970\xa0years [odds ratio (OR) 2.1, 95% confidence interval (CI) ' '1.2–3.8, p\u2009=\u20090.011]; uncontrolled hematological malignancy (OR 2.9, 95% CI 1.6–5.2, ' 'p\u2009&lt;\u20090.0001); ECOG 3–4 (OR, 2.56, 95% CI 1.4–4.7, p\u2009=\u20090.003); ' 'neutropenia (&lt;\u20090.5\u2009×\u200910<jats:sup>9</jats:sup>/L) (OR 2.8, 95% CI 1.3–6.1, ' 'p\u2009=\u20090.01); and a C-reactive protein (CRP)\u2009&gt;\u200920\xa0mg/dL (OR 3.3, 95% ' 'CI 1.7–6.4, p\u2009&lt;\u20090.0001). In multivariate analysis of 216 patients with very ' 'severe COVID-19, treatment with azithromycin or low dose corticosteroids was associated with ' 'lower OM (OR 0.42, 95% CI 0.2–0.89 and OR 0.31, 95% CI 0.11–0.87, respectively, p\u2009=\u2009' '0.02) whereas the use of hidroxycloroquine did not show significant improvement in OM (OR ' '0.64, 95% CI 0.37–1.1, P\u2009=\u2009' '0.1).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>In most ' 'patients with hematological malignancies COVID-19 mortality was directly driven by older age, ' 'disease status, performance status, as well as by immune (neutropenia) parameters and level ' 'of inflammation (high CRP). Use of azithromycin and low dose corticosteroids may be of value ' 'in very severe COVID-19.</jats:p></jats:sec>', 'DOI': '10.1186/s40164-020-00177-z', 'type': 'journal-article', 'created': {'date-parts': [[2020, 8, 25]], 'date-time': '2020-08-25T12:02:43Z', 'timestamp': 1598356963000}, 'update-policy': 'http://dx.doi.org/10.1007/springer_crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 109, 'title': 'Risk factors and outcome of COVID-19 in patients with hematological malignancies', 'prefix': '10.1186', 'volume': '9', 'author': [ { 'ORCID': 'http://orcid.org/0000-0001-8533-2562', 'authenticated-orcid': False, 'given': 'José Luis', 'family': 'Piñana', 'sequence': 'first', 'affiliation': []}, {'given': 'Rodrigo', 'family': 'Martino', 'sequence': 'additional', 'affiliation': []}, {'given': 'Irene', 'family': 'García-García', 'sequence': 'additional', 'affiliation': []}, {'given': 'Rocío', 'family': 'Parody', 'sequence': 'additional', 'affiliation': []}, {'given': 'María 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Local ethics committee approved the ' 'study protocol (reference code 2020-113-1), registered by the Spanish Agency of ' 'Medicines and Health Products with the reference code GETCLO-2020-01 and by the ' 'European Medicines Agency with the reference code EUPAS34365EBMT.', 'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics approval and consent to participate'}}, { 'value': 'The participants provided informed consent for the publication of the study.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for publication'}}, { 'value': 'The author(s) declare that they have no conflict of interests.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}], 'article-number': '21'}