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

Pagano, Livio; Salmanton-García, Jon; Marchesi, Francesco; Busca, Alessandro; Corradini, Paolo; Hoenigl, Martin; Klimko, Nikolai; Koehler, Philipp; Pagliuca, Antonio; Passamonti, Francesco; Verga, Luisa; Víšek, Benjamin; Ilhan, Osman; Nadali, Gianpaolo; Weinbergerová, Barbora; Córdoba-Mascuñano, Raúl; Marchetti, Monia; Collins, Graham P.; Farina, Francesca; Cattaneo, Chiara; Cabirta, Alba; Gomes-Silva, Maria; Itri, Federico; van Doesum, Jaap; Ledoux, Marie-Pierre; Čerňan, Martin; Jakšić, Ozren; Duarte, Rafael F.; Magliano, Gabriele; Omrani, Ali S.; Fracchiolla, Nicola S.; Kulasekararaj, Austin; Valković, Toni; Poulsen, Christian Bjørn; Machado, Marina; Glenthøj, Andreas; Stoma, Igor; Ráčil, Zdeněk; Piukovics, Klára; Navrátil, Milan; Emarah, Ziad; Sili, Uluhan; Maertens, Johan; Blennow, Ola; Bergantim, Rui; García-Vidal, Carolina; Prezioso, Lucia; Guidetti, Anna; del Principe, Maria Ilaria; Popova, Marina; de Jonge, Nick; Ormazabal-Vélez, Irati; Fernández, Noemí; Falces-Romero, Iker; Cuccaro, Annarosa; Meers, Stef; Buquicchio, Caterina; Antić, Darko; Al-Khabori, Murtadha; García-Sanz, Ramón; Biernat, Monika M.; Tisi, Maria Chiara; Sal, Ertan; Rahimli, Laman; Čolović, Natasa; Schönlein, Martin; Calbacho, Maria; Tascini, Carlo; Miranda-Castillo, Carolina; Khanna, Nina; Méndez, Gustavo-Adolfo; Petzer, Verena; Novák, Jan; Besson, Caroline; Duléry, Rémy; Lamure, Sylvain; Nucci, Marcio; Zambrotta, Giovanni; Žák, Pavel; Seval, Guldane Cengiz; Bonuomo, Valentina; Mayer, Jiří; López-García, Alberto; Sacchi, Maria Vittoria; Booth, Stephen; Ciceri, Fabio; Oberti, Margherita; Salvini, Marco; Izuzquiza, Macarena; Nunes-Rodrigues, Raquel; Ammatuna, Emanuele; Obr, Aleš; Herbrecht, Raoul; Núñez-Martín-Buitrago, Lucía; Mancini, Valentina; Shwaylia, Hawraa; Sciumè, Mariarita; Essame, Jenna; Nygaard, Marietta; Batinić, Josip; Gonzaga, Yung; Regalado-Artamendi, Isabel; Karlsson, Linda Katharina; Shapetska, Maryia; Hanakova, Michaela; El-Ashwah, Shaimaa; Borbényi, Zita; Çolak, Gökçe Melis; Nordlander, Anna; Dragonetti, Giulia; Maraglino, Alessio Maria Edoardo; Rinaldi, Amelia; De Ramón-Sánchez, Cristina; Cornely, Oliver A.

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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13045-021-01177-0.