COVID-19 in hematology: data from a hematologic and transplant unit

Area of Science:

• Hematology
• Infectious Diseases
• Transplant Surgery
• Public Health

Background:

• The COVID-19 pandemic necessitated adaptations in cancer care to protect vulnerable patients.
• Hematological and Stem Cell Transplant (HSCT) units are particularly susceptible to disruptions and infections.
• Understanding SARS-CoV-2 transmission dynamics within these units is crucial for patient safety.

Purpose of the Study:

• To describe the preparation and initial response of a Brazilian HSCT unit during the early COVID-19 pandemic.
• To report the incidence and characteristics of COVID-19 cases among hematological patients and healthcare workers (HCW).
• To evaluate the safety and feasibility of continuing HSCT and onco-hematological treatments amidst the pandemic.

Main Methods:

• Implementation of modified routines, including area/professional separation and SARS-CoV-2 screening.
• PCR testing for SARS-CoV-2 conducted on 47 patients and 54 HCW.
• Retrospective analysis of COVID-19 cases, treatment outcomes, and HSCT program activity.

Main Results:

• 11 COVID-19 cases identified in hematological patients (2 post-SCT), with severe/moderate presentations and poor risk factors.
• 28 COVID-19 cases in HCW, predominantly mild with full recovery; a cluster was noted.
• Despite reduced procedures, 8 autologous and 4 allogeneic SCT were performed; 49 patients received ongoing treatment.

Conclusions:

• High SARS-CoV-2 prevalence was observed in both patients and HCW, indicating community spread in Brazil.
• Strict containment measures enabled the safe continuation of critical hematological treatments and HSCT during the pandemic.
• The study demonstrates the resilience of HSCT programs in managing cancer care during public health crises.