Clinical Characteristics and Outcome of COVID-19 in Turkish Hematological Malignancy Patients

Civriz Bozdag, Sinem; Cengiz Seval, Güldane; Yönal Hindilerden, Ipek; Hindilerden, Fehmi; Andiç, Neslihan; Baydar, Mustafa; Aydin Kaynar, Lale; Koçak Toprak, Selami; Göksoy, Hasan Sami; Balik Aydin, Berrin; Demirci, Ufuk; Can, Ferda; Özkocaman, Vildan; Gündüz, Eren; Güven, Zeynep Tugba; Özkurt, Zübeyde Nur; Demircioglu, Sinan; Beksaç, Meral; Ince, Idris; Yilmaz, Umut; Eroglu Küçükdiler, Hilal; Abishov, Elgün; Yavuz, Boran; Atas, Ünal; Mutlu, Yasa Gül; Bas, Volkan; Özkalemkas, Fahir; Üsküdar Teke, Hava; Gürsoy, Vildan; Çelik, Serhat; Çiftçiler, Rafiye; Yagci, Münci; Topçuoglu, Pervin; Çeneli, Özcan; Abbasov, Hamza; Selim, Cem; Ar, Muhlis Cem; Yücel, Orhan Kemal; Sadri, Sevil; Albayrak, Canan; Demir, Ahmet Muzaffer; Güler, Nil; Keklik, Muzaffer; Terzi, Hatice; Dogan, Ali; Yegin, Zeynep Arzu; Kurt Yüksel, Meltem; Sadri, Sogol; Yavasoglu, Irfan; Beköz, Hüseyin Saffet

Patients with solid malignancies are more vulnerable to SARS-CoV-2 infection than healthy population. The outcome of SARS-CoV-2 infection in highly immunosupressed populations, such as in patients with hematological malignancies is a point of interest.We aimed to analyze the symptoms, complications, intensive care unit (ICU) admission and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. In this multicenter study, we included 340 adult and pediatric patients diagnosed as COVID-19 from March to November. Forty four (12.9%) patients were asymptomatic at diagnosis. In symptomatic patients, fever, cough and dyspnea were observed in 62.6%, 48.8 % and 41.8% of the patients, respectively. Sixty nine (20%) patients had mild SARS-Cov-2 disease, whereas moderate, severe and critical diseases were reported in 101 (29%), 71 (20%) and 55 (16%) patients, respectively. Two hundered fifty one (73.8%) patients were hospitalized for SARS-Cov2. Mortality related to SARS-CoV-2 infection was 26.5% in all cohort; 4.4% in those patients with mild disease, 12.4% in moderate disease and 83% in severe and critical disease. Active hematological disease, lower life expectancy related with primary hematological disease, neutropenia at diagnosis of SARS- CoV-2, ICU admission and first-line therapy used for COVID 19 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azitromycin were associated with a higher rate of mortality in comparison with favipiravir use.In conclusion, patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.