Clinical course and risk factors for mortality from COVID-19 in patients with haematological malignancies.

Sanchez-Pina, José María; Rodríguez Rodriguez, Mario; Castro Quismondo, Nerea; Gil Manso, Rodrigo; Colmenares, Rafael; Gil Alos, Daniel; Paciello, Mari Liz; Zafra, Denis; Garcia-Sanchez, Cristina; Villegas, Carolina; Cuellar, Clara; Carreño, Gonzalo; Zamanillo, Irene; Poza, María; Iñiguez, Rodrigo; Gutierrez, Xabier; Alonso, Rafael; Rodríguez, Antonia; Folgueira, Maria Dolores; Delgado, Rafael; Ferrari, José Miguel; Lizasoain, Manuel; Aguado, José María; Ayala, Rosa; Martinez-Lopez, Joaquín; Calbacho, María

BACKGROUND The impact of coronavirus disease 2019 (COVID-19) in haematological patients (HP) has not been reported to date. METHODS We analyzed 39 patients with SARS-CoV-2 infection and haematological malignancies. Clinical characteristics and outcomes were compared to a matched control group of 53 non-cancer patients with COVID-19. Univariate and multivariate analyses were carried out to assess the risk factors associated with poor outcome. RESULTS The most frequent haematological diseases were lymphoma (30%) and multiple myeloma (30%). Eighty-seven % HP developed moderate or severe disease. Patients with haematological malignancies had a significantly higher mortality rate compared to non-cancer patients (35.9% vs 13.2%; P=0.003 (odds ratio 6.652). The worst outcome was observed in chronic lymphocytic leukemia patients. Only age >70 years and C reactive protein >10 mg/dl at admission were associated with higher risk of death (odds ratio 34.86, p= 0.003 and 13.56, p=0.03). Persistant viral sheddind was detected in 5 HP. Active chemotherapy, viral load at diagnosis and COVID-19 therapy were not predictors of outcome. CONCLUSION Mortality of COVID-19 is significantly higher in patients with haematological malignancies compared to non-cancer patients. The impact of persistant viral shedding must be considered in order to re-start therapies and maintain infectious control measures.