Clinical Characteristics of Hematological Patients Concomitant with COVID‐19

Zhou, Xiaoxi; Wang, Gaoxiang; Chen, Liting; Meng, Fankai; Huang, Liang; Huang, Lifang; Wang, Na; Li, Tongjuan; Cao, Yang; Zhou, Jianfeng

The rapid spread of COVID‐19 represented the most serious issue to public health globally. Hematological patients as immunocompromised hosts are vulnerable to SARS‐CoV‐2 infection. There is rare information available regarding the clinical features of hematological patients concomitant with COVID‐19. In this study, 9 concomitant patients were analyzed for their clinical manifestations, the laboratory data, radiological findings and immunologic features. The median age was 50 years (range, 17‐68) and 6 patients were male. 7 patients were infected via hospital‐associated transmission and other 2 via community‐associated transmission. Onset of COVID‐19 in all patients occurred during routine treatments for their hematological diseases. 8 patients were classified as moderate and 1 patient as critically ill COVID‐19. 4 patients died, 1 from leukemia progression, 2 from life‐threatening secondary infection and the other one from respiratory failure caused by COVID‐19. Abruptly elevated level of cytokines was often correlated with progressive hematological disease or concurrent bacterial infections. 2 patients had the atypical CT imaging findings of COVID‐19. The median interval from the first CT scan imaging to improvement in survivors was 40 days (range 14‐51 days). 4 out of 5 survivors had negative serological tests one month after symptoms onset. Positive viral load in 4 survivors lasted longer than 45 days. Our result indicated concomitant patients formed a distinct subgroup characterized by atypical clinical features, defective viral clearance and lower level of SARS‐CoV‐2‐specific antibodies. Targeted therapies that impair host humoral immunity should be avoided. These findings will be helpful to tailor appropriate management for the concomitant patients.