Risk factors and outcomes of COVID-19 in adult patients with hematological malignancies: A single-center study showing lower than expected rates of hospitalization and mortality

Eur J Haematol. 2023 Jul;111(1):135-145. doi: 10.1111/ejh.13977. Epub 2023 Apr 24.

Abstract

Background: Studies addressing coronavirus disease 2019 (COVID-19) in patients with hematological malignancies have reported mortality rates of up to 40%; however, included predominantly hospitalized patients.

Methods: During the first year of the pandemic, we followed adult patients with hematological malignancies treated at a tertiary center in Jerusalem, Israel, who contracted COVID-19, with the aim of studying risk factors for adverse COVID-19-related outcomes. We used remote communication to track patients managed at home-isolation, and patient questioning to assess the source of COVID-19 infection, community versus nosocomial.

Results: Our series included 183 patients, median age was 62.5 years, 72% had at least one comorbidity and 39% were receiving active antineoplastic treatment. Hospitalization, critical COVID-19, and mortality rates were 32%, 12.6%, and 9.8%, respectively, remarkably lower than previously reported. Age, multiple comorbidities, and active antineoplastic treatment were significantly associated with hospitalization due to COVID-19. Treatment with monoclonal antibodies was strongly associated with both hospitalization and critical COVID-19. In older (≥60) patients not receiving active antineoplastic treatment, mortality, and severe COVID-19 rates were comparable to those of the general Israeli population. We did not detect patients that contracted COVID-19 within the Hematology Division.

Conclusion: These findings are relevant for the future management of patients with hematological malignancies in COVID-19-affected regions.

Keywords: COVID-19; anti-CD20 antibodies; hematological malignancies; hematological neoplasms; monoclonal antibodies.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents*
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • Hematologic Neoplasms* / complications
  • Hematologic Neoplasms* / epidemiology
  • Hematologic Neoplasms* / therapy
  • Hospitalization
  • Humans
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2

Substances

  • Antineoplastic Agents