[HTML][HTML] COVID-19 outcomes in patients with hematologic disease

F Malard, A Genthon, E Brissot… - Bone Marrow …, 2020 - nature.com
F Malard, A Genthon, E Brissot, Z van de Wyngaert, Z Marjanovic, S Ikhlef, A Banet…
Bone Marrow Transplantation, 2020nature.com
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a novel coronavirus of
zoonotic origin that emerged in China at the end of 2019. The infection, named Coronavirus
Disease 2019 (COVID-19), is now spreading worldwide. As of April 16, 2020, the virus had
affected more than 2,000,000 individuals and resulted in over 125,000 deaths worldwide.
Mortality can be as high as 15% in elderly patients, and/or in patients with comorbidities [1,
2]. Based on the current available data, the incubation period (time from exposure to …
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a novel coronavirus of zoonotic origin that emerged in China at the end of 2019. The infection, named Coronavirus Disease 2019 (COVID-19), is now spreading worldwide. As of April 16, 2020, the virus had affected more than 2,000,000 individuals and resulted in over 125,000 deaths worldwide. Mortality can be as high as 15% in elderly patients, and/or in patients with comorbidities [1, 2]. Based on the current available data, the incubation period (time from exposure to symptom development) is estimated as between 2 and 14 days [3]. At present, there are no approved treatment options in Europe and no available vaccine. Avoiding exposure by adhering to recommended hygiene procedures, isolation of infected persons and social distancing are the only prevention strategies recommended by the WHO [4]. Risk factors for COVID-19 severity and death include older age, along with comorbidities such as diabetes, hypertension, or cardiac disease [1, 2]. In addition, data from China suggest that patients with cancer have a significantly higher incidence of severe events (including intensive care unit admission, need of assisted ventilation, death) after contracting the virus (39% versus 8% in patients without cancer)[5]. Another study reported that cancer patients appear to be twice as likely to contract infection with SARS-CoV-2 [6]. Importantly, that study suggests that hospital admission and recurrent hospital visits, inherent to cancer patients’ management, are potential risk factors for SARS-CoV-2 infection [6]. To date, very few data are available on COVID-19 outcomes in patients with hematologic diseases. Only one 47-year-old patient with a lymphoma has been included in a previous report [5], and two articles have reported on the course of COVID-19 infection in a 39-year-old patient with chronic lymphocytic leukemia [7] and in a 60-year-old patient with multiple myeloma (MM)[8]. All three patients had a favorable outcome. Nevertheless, these were relatively young, unlike the overall patient population with hematologic neoplasms which is usually aged, comorbid and highly immunosuppressed. These patients are therefore expected to be a particularly vulnerable group for COVID-19. A better characterization of those infected with the virus is important. Here we describe the demographic characteristics, coexisting conditions, imaging findings, and outcomes among patients with hematologic disease and COVID-19 infection. We included all consecutive adult patients with a hematologic disease admitted to the Hematology Department (inpatient and outpatient admissions) of the Saint-Antoine-Hospital, AP-HP, Paris, France, with laboratoryconfirmed COVID-19 infection between March 9 and April 4, 2020 and with at least 10 days of follow-up. A confirmed case of COVID-19 was defined by a positive result on a real-time RT-PCR assay of a specimen collected on a nasopharyngeal swab. We reviewed medical records to collect demographic, clinical, and treatment data and outcomes of COVID-19. All laboratory tests and radiologic assessments, including plain chest radiography and computerized chest tomography, were performed at the discretion of the treating physician.
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