Acute leukemia and SARS-CoV-2 infection: clinical characteristics and risk factors for mortality

Area of Science:

• Hematology
• Infectious Diseases
• Oncology

Background:

• Acute leukemia (AL) patients exhibit elevated mortality rates when concurrently infected with coronavirus disease 2019 (COVID-19).
• Limited research exists on the clinical characteristics and outcomes of AL patients diagnosed with COVID-19.

Discussion:

• COVID-19 pneumonia was the direct cause of death in all fatalities observed.
• Disease status, particularly newly diagnosed AL and bone marrow aplasia, significantly worsens patient prognosis.
• Biomarkers such as low platelet count, prolonged prothrombin time (PT), elevated ISTH DIC score, C-reactive protein (CRP), and lactate dehydrogenase (LDH) correlate with increased mortality.

Key Insights:

• The mortality rate among the 51 studied AL patients with COVID-19 was 29.4%.
• Risk stratification based on disease status and laboratory markers is crucial for managing AL patients with COVID-19.
• Intrahospital transmission of COVID-19 was frequent (50.98%), underscoring the need for strict isolation protocols.

Outlook:

• Careful consideration of the risk-benefit balance for continuing antineoplastic therapy is essential, especially for patients on nonintensive or supportive care.
• Prioritizing single-room isolation, continuous symptom monitoring, and regular testing for AL patients is critical to mitigate intrahospital transmission.
• Further research is needed to develop targeted strategies for preventing and managing COVID-19 in immunocompromised hematological malignancy patients.