Clinical outcomes and risk factors for severe COVID‐19 infection in patients with haematological disorders receiving chemo‐ or immunotherapy

Fox, TA; Troy‐Barnes, E; Kirkwood, AA; Chan, WY; Day, J; Chavda, SJ; Kumar, EA; David, K; Tomkins, O; Sanchez, E; Scully, M; Khwaja, A; Lambert, J; Singer, M; Roddie, C; Morris, EC; Yong, KL; Thomson, KJ; Ardeshna, KM

Haematology patients receiving chemo‐ or immunotherapy are considered to be at greater risk of COVID‐19‐related morbidity and mortality. We aimed to identify risk factors for COVID‐19 severity and assess outcomes in patients where COVID‐19 complicated the treatment of their haematological disorder. A retrospective cohort study was conducted in 55 patients with haematological disorders and COVID‐19, including 52 with malignancy, 2 with bone marrow failure and 1 immune mediated thrombotic thrombocytopenic purpura (TTP). COVID‐19 diagnosis coincided with a new diagnosis of a haematological malignancy in four patients. 82% of patients were on systemic anti‐cancer therapy (SACT) at time of COVID‐19. Of hospitalised patients, 37% (19/51) died whilst all four outpatients recovered. Risk factors for severe disease or mortality were similar to other published cohorts. Raised CRP at diagnosis predicted an aggressive clinical course. The majority of patients recovered from COVID‐19, despite receiving recent SACT. This suggests that SACT, where urgent, should be administered despite intercurrent CV19 infection, which should be managed according to standard pathway. Delay or modification of therapy should be considered on an individual basis. Long‐term follow‐up studies in larger patient cohorts are required to assess efficacy of treatment strategies employed during the pandemic.