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

Livio Pagano; Jon Salmanton-García; Francesco Marchesi; Alessandro Busca; Paolo Corradini; Martin Hoenigl; Nikolai Klimko; Philipp Koehler; Antonio Pagliuca; Francesco Passamonti; Luisa Verga; Benjamin Víšek; Osman Ilhan; Gianpaolo Nadali; Barbora Weinbergerová; Raúl Córdoba-Mascuñano; Monia Marchetti; Graham P Collins; Francesca Farina; Chiara Cattaneo; Alba Cabirta; Maria Gomes-Silva; Federico Itri; Jaap van Doesum; Marie-Pierre Ledoux; Martin Čerňan; Ozren Jakšić; Rafael F Duarte; Gabriele Magliano; Ali S Omrani; Nicola S Fracchiolla; Austin Kulasekararaj; Toni Valković; Christian Bjørn Poulsen; Marina Machado; Andreas Glenthøj; Igor Stoma; Zdeněk Ráčil; Klára Piukovics; Milan Navrátil; Ziad Emarah; Uluhan Sili; Johan Maertens; Ola Blennow; Rui Bergantim; Carolina García-Vidal; Lucia Prezioso; Anna Guidetti; Marietta Nygaard; Linda Katharina Karlsson; EPICOVIDEHA working group

doi:10.1186/s13045-021-01177-0

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

Livio Pagano, Jon Salmanton-García, Francesco Marchesi, Alessandro Busca, Paolo Corradini, Martin Hoenigl, Nikolai Klimko, Philipp Koehler, Antonio Pagliuca, Francesco Passamonti, Luisa Verga, Benjamin Víšek, Osman Ilhan, Gianpaolo Nadali, Barbora Weinbergerová, Raúl Córdoba-Mascuñano, Monia Marchetti, Graham P Collins, Francesca Farina, Chiara CattaneoAlba Cabirta, Maria Gomes-Silva, Federico Itri, Jaap van Doesum, Marie-Pierre Ledoux, Martin Čerňan, Ozren Jakšić, Rafael F Duarte, Gabriele Magliano, Ali S Omrani, Nicola S Fracchiolla, Austin Kulasekararaj, Toni Valković, Christian Bjørn Poulsen, Marina Machado, Andreas Glenthøj, Igor Stoma, Zdeněk Ráčil, Klára Piukovics, Milan Navrátil, Ziad Emarah, Uluhan Sili, Johan Maertens, Ola Blennow, Rui Bergantim, Carolina García-Vidal, Lucia Prezioso, Anna Guidetti, Marietta Nygaard, Linda Katharina Karlsson, EPICOVIDEHA working group

Department of Haematology

222 Citations (Scopus)

Abstract

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.

Original language	English
Article number	168
Journal	Journal of Hematology & Oncology
Volume	14
Issue number	1
Pages (from-to)	168
ISSN	1756-8722
DOIs	https://doi.org/10.1186/s13045-021-01177-0
Publication status	Published - 14 Oct 2021

Keywords

Adult
Aged
Aged, 80 and over
COVID-19/complications
Europe/epidemiology
Female
Hematologic Neoplasms/complications
Hospitalization
Humans
Intensive Care Units
Male
Middle Aged
Registries
Risk Factors
SARS-CoV-2/isolation & purification
Young Adult
Pandemic
Epidemiology
Hematological malignancies
COVID-19
EHA

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Pagano, L., Salmanton-García, J., Marchesi, F., Busca, A., Corradini, P., Hoenigl, M., Klimko, N., Koehler, P., Pagliuca, A., Passamonti, F., Verga, L., Víšek, B., Ilhan, O., Nadali, G., Weinbergerová, B., Córdoba-Mascuñano, R., Marchetti, M., Collins, G. P., Farina, F., ... EPICOVIDEHA working group (2021). COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA). Journal of Hematology & Oncology, 14(1), 168. Article 168. https://doi.org/10.1186/s13045-021-01177-0

Pagano, L, Salmanton-García, J, Marchesi, F, Busca, A, Corradini, P, Hoenigl, M, Klimko, N, Koehler, P, Pagliuca, A, Passamonti, F, Verga, L, Víšek, B, Ilhan, O, Nadali, G, Weinbergerová, B, Córdoba-Mascuñano, R, Marchetti, M, Collins, GP, Farina, F, Cattaneo, C, Cabirta, A, Gomes-Silva, M, Itri, F, van Doesum, J, Ledoux, M-P, Čerňan, M, Jakšić, O, Duarte, RF, Magliano, G, Omrani, AS, Fracchiolla, NS, Kulasekararaj, A, Valković, T, Poulsen, CB, Machado, M, Glenthøj, A, Stoma, I, Ráčil, Z, Piukovics, K, Navrátil, M, Emarah, Z, Sili, U, Maertens, J, Blennow, O, Bergantim, R, García-Vidal, C, Prezioso, L, Guidetti, A, Nygaard, M, Karlsson, LK & EPICOVIDEHA working group 2021, 'COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA)', Journal of Hematology & Oncology, vol. 14, no. 1, 168, pp. 168. https://doi.org/10.1186/s13045-021-01177-0

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

abstract = "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.",

keywords = "Adult, Aged, Aged, 80 and over, COVID-19/complications, Europe/epidemiology, Female, Hematologic Neoplasms/complications, Hospitalization, Humans, Intensive Care Units, Male, Middle Aged, Registries, Risk Factors, SARS-CoV-2/isolation & purification, Young Adult, Pandemic, Epidemiology, Hematological malignancies, COVID-19, EHA",

author = "Livio Pagano and Jon Salmanton-Garc{\'i}a and Francesco Marchesi and Alessandro Busca and Paolo Corradini and Martin Hoenigl and Nikolai Klimko and Philipp Koehler and Antonio Pagliuca and Francesco Passamonti and Luisa Verga and Benjamin V{\'i}{\v s}ek and Osman Ilhan and Gianpaolo Nadali and Barbora Weinbergerov{\'a} and Ra{\'u}l C{\'o}rdoba-Mascu{\~n}ano and Monia Marchetti and Collins, {Graham P} and Francesca Farina and Chiara Cattaneo and Alba Cabirta and Maria Gomes-Silva and Federico Itri and {van Doesum}, Jaap and Marie-Pierre Ledoux and Martin {\v C}er{\v n}an and Ozren Jak{\v s}i{\'c} and Duarte, {Rafael F} and Gabriele Magliano and Omrani, {Ali S} and Fracchiolla, {Nicola S} and Austin Kulasekararaj and Toni Valkovi{\'c} and Poulsen, {Christian Bj{\o}rn} and Marina Machado and Andreas Glenth{\o}j and Igor Stoma and Zden{\v e}k R{\'a}{\v c}il and Kl{\'a}ra Piukovics and Milan Navr{\'a}til and Ziad Emarah and Uluhan Sili and Johan Maertens and Ola Blennow and Rui Bergantim and Carolina Garc{\'i}a-Vidal and Lucia Prezioso and Anna Guidetti and Marietta Nygaard and Karlsson, {Linda Katharina} and {EPICOVIDEHA working group}",

note = "{\textcopyright} 2021. The Author(s).",

year = "2021",

month = oct,

day = "14",

doi = "10.1186/s13045-021-01177-0",

language = "English",

volume = "14",

pages = "168",

journal = "Journal of Hematology & Oncology",

issn = "1756-8722",

publisher = "BioMed Central Ltd",

number = "1",

}

TY - JOUR

T1 - COVID-19 infection in adult patients with hematological malignancies

T2 - a European Hematology Association Survey (EPICOVIDEHA)

AU - Pagano, Livio

AU - Salmanton-García, Jon

AU - Marchesi, Francesco

AU - Busca, Alessandro

AU - Corradini, Paolo

AU - Hoenigl, Martin

AU - Klimko, Nikolai

AU - Koehler, Philipp

AU - Pagliuca, Antonio

AU - Passamonti, Francesco

AU - Verga, Luisa

AU - Víšek, Benjamin

AU - Ilhan, Osman

AU - Nadali, Gianpaolo

AU - Weinbergerová, Barbora

AU - Córdoba-Mascuñano, Raúl

AU - Marchetti, Monia

AU - Collins, Graham P

AU - Farina, Francesca

AU - Cattaneo, Chiara

AU - Cabirta, Alba

AU - Gomes-Silva, Maria

AU - Itri, Federico

AU - van Doesum, Jaap

AU - Ledoux, Marie-Pierre

AU - Čerňan, Martin

AU - Jakšić, Ozren

AU - Duarte, Rafael F

AU - Magliano, Gabriele

AU - Omrani, Ali S

AU - Fracchiolla, Nicola S

AU - Kulasekararaj, Austin

AU - Valković, Toni

AU - Poulsen, Christian Bjørn

AU - Machado, Marina

AU - Glenthøj, Andreas

AU - Stoma, Igor

AU - Ráčil, Zdeněk

AU - Piukovics, Klára

AU - Navrátil, Milan

AU - Emarah, Ziad

AU - Sili, Uluhan

AU - Maertens, Johan

AU - Blennow, Ola

AU - Bergantim, Rui

AU - García-Vidal, Carolina

AU - Prezioso, Lucia

AU - Guidetti, Anna

AU - Nygaard, Marietta

AU - Karlsson, Linda Katharina

AU - EPICOVIDEHA working group

PY - 2021/10/14

Y1 - 2021/10/14

N2 - 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.

AB - 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.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - COVID-19/complications

KW - Europe/epidemiology

KW - Female

KW - Hematologic Neoplasms/complications

KW - Hospitalization

KW - Humans

KW - Intensive Care Units

KW - Male

KW - Middle Aged

KW - Registries

KW - Risk Factors

KW - SARS-CoV-2/isolation & purification

KW - Young Adult

KW - Pandemic

KW - Epidemiology

KW - Hematological malignancies

KW - COVID-19

KW - EHA

UR - http://www.scopus.com/inward/record.url?scp=85117512005&partnerID=8YFLogxK

U2 - 10.1186/s13045-021-01177-0

DO - 10.1186/s13045-021-01177-0

M3 - Journal article

C2 - 34649563

SN - 1756-8722

VL - 14

SP - 168

JO - Journal of Hematology & Oncology

JF - Journal of Hematology & Oncology

IS - 1

M1 - 168

ER -

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

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