Clinical Course of Covid-19 in Hematological Disorders

Atay, M. H.; Okuyucu, M.; Gullu, Y. T.; Tuna, N. T.; Bilek, H. C.; Tanyel, E.; Terzi, O.; Turgut, M.

Hematology patients are extremely vulnerable to COVID-19 infection due to the immunosuppression arising from the direct effect of the disease and the medicines administered. Our purpose is to analyze the results of the patients that both have a hematological disease and receive treatment for COVID-19 infection in our hospital. Four hundred COVID-19 positive patients that received inpatient treatment between March 12, 2020 and October 1, 2020 in our center and got a diagnosis by using real -time polymerase chain reaction (RT-PCR) test were scanned retrospectively. Eighty one patients were included in the study. Nineteen patients had a hematological disease;62 had a chronic disease but didn't have a hematological disease. We found that the group with hematological disease had a high level of ferritin (p= 0.0001). While the use of steroids in COVID-19 treatments is more frequent in the group with hematological disease (p= 0.01), the use of LMWH (low molecular weight heparin) is more frequent in the group with no hematological diseases (p= 0.02). Intensive care treatment and mechanical ventilatory support were required more for the patients with hematological disease than the others (p= 0.03. p= 0.008). While the mortality rate is 42.1% in the patients with hematological disease, it is 9.7% in the patients with chronic disease (p= 0.003). In cox regression analysis, the study found that hematological diseases (HR: 4.02, 95% CI: 1.7-1844.5, p= 0.02), cardiac diseases (HR: 2.28, 95% CI: 1.2-77.9, p= 0.03), and intensive care treatment (HR: 4.60, 95% CI: 3.1-3115.0, p= 0.009) are significant risk factors. Hematological patients infected with COVID-19 have a more severe and mortal clinical manifestation than the patients with other chronical disease.