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Clinical characteristics and mortality of patients with hematologic malignancies and COVID-19: a systematic review
1Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea. AZSAGM@yuhs.ac.
Insights
Patients with hematologic malignancies and Coronavirus Disease 2019 (COVID-19) face severe illness. This review highlights their higher mortality risk compared to the general population, emphasizing the need for specialized care.
Area of Science:
- Hematology
- Infectious Diseases
- Oncology
Background:
- Patients with hematologic malignancies are a vulnerable group during the Coronavirus Disease 2019 (COVID-19) pandemic.
- Hematologic cancer patients often experience more severe COVID-19 outcomes compared to the general population.
Purpose of the Study:
- To comprehensively review and analyze the clinical characteristics and mortality of patients with hematologic malignancies who are co-infected with COVID-19.
- To compare the clinical and laboratory features and outcomes of COVID-19 in patients with and without hematologic malignancies.
Main Methods:
- A systematic literature search of PubMed was conducted up to June 03, 2020.
- 16 relevant case studies (33 cases) were identified and analyzed for clinical and laboratory characteristics, including malignancy type, symptoms, and outcomes.
- Data were compared between patients with hematologic malignancies and COVID-19 and the general COVID-19 population.
Main Results:
- The median age of affected patients was 66 years, with chronic lymphocytic leukemia being the most common malignancy (39.4%).
- COVID-19 patients with hematologic malignancies showed higher prevalence of dyspnea, leukocytosis, lymphocytosis, and thrombocytopenia compared to those without malignancies.
- Mortality was significantly higher in patients with hematologic malignancies (40.0%) versus those without (3.6%).
Conclusions:
- The co-occurrence of hematologic malignancies and COVID-19, while rare, is associated with a substantially elevated mortality rate.
- No specific clinical or laboratory factors were identified as predictors of mortality within the hematologic malignancy patient group.
- Further research into tailored treatment and management strategies for this high-risk population is crucial.
Objective:
Hematologic cancer patients with Coronavirus Disease 2019 (COVID-19) tend to have a more serious disease course than observed in the general population. Herein, we comprehensively reviewed existing literature and analyzed clinical characteristics and mortality of patients with hematologic malignancies and COVID-19.
Materials And Methods:
Through searching PubMed until June 03, 2020, we identified 16 relevant case studies (33 cases) from a total of 45 studies that have reported on patients with COVID-19 and hematologic malignancies. We investigated the clinical and laboratory characteristics including type of hematologic malignancies, initial symptoms, laboratory findings, and clinical outcomes. Then, we compared those characteristics and outcomes of patients with hematologic malignancies and COVID-19 to the general population infected with COVID-19.
Results:
The median age was 66-year-old. Chronic lymphocytic leukemia was the most common type of hematologic malignancy (39.4%). Fever was the most common symptom (75.9%). Most patients had normal leukocyte counts (55.6%), lymphocytosis (45.4%), and normal platelet counts (68.8%). In comparison to patients with COVID-19 without underlying hematologic malignancies, dyspnea was more prevalent (45.0 vs. 24.9%, p=0.025). Leukocytosis (38.9 vs. 9.8%, p=0.001), lymphocytosis (45.4 vs. 8.2%, p=0.001), and thrombocytopenia (31.3 vs. 11.4%, p=0.036) were significantly more prevalent and lymphopenia (18.2 vs. 57.4%, p=0.012) less prevalent in patients with hematologic malignancies. There were no clinical and laboratory characteristics predicting mortality in patients with hematologic malignancies. Mortality was much higher in patients with hematologic malignancies compared to those without this condition (40.0 vs. 3.6%, p<0.001).
Conclusions:
Co-occurrence of hematologic malignancies and COVID-19 is rare. However, due to the high mortality rate from COVID-19 in this vulnerable population, further investigation on tailored treatment and management is required.
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