Are Hematologic Patients Trojan Horse for COVID-19?

Emrah Kılıçaslan1, Işıl Erdoğan Özünal1, Tayfun Elibol1

  • 1Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey.

Insights

Patients with hematologic diseases (HD) shed SARS-CoV-2 for longer periods compared to controls. This suggests longer isolation may be needed for COVID-19 patients with HD.

Area of Science:

  • Infectious Diseases
  • Hematology
  • Public Health

Background:

  • Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, remains a global health concern.
  • Patients with hematologic diseases (HD) may have different clinical outcomes and viral shedding patterns compared to the general population.

Purpose of the Study:

  • To compare SARS-CoV-2 viral shedding time between patients with hematologic diseases (HD) and a control group.
  • To analyze differences in COVID-19 severity, intensive care unit (ICU) needs, and mortality rates between these groups.

Main Methods:

  • A retrospective study involving 110 patients (55 with HD, 55 controls) diagnosed with COVID-19.
  • Comparison of viral shedding duration, disease severity, ICU admission, and mortality between the HD group and the control group.

Main Results:

  • Median viral shedding time was significantly longer in hospitalized HD patients (24 days) versus controls (12 days) (p<0.01).
  • Outpatient HD patients also showed longer shedding (20 days) compared to controls (10 days) (p=0.02).
  • Severe-to-critical COVID-19 was more frequent in the HD group (47.2%) than controls (25.4%) (p=0.017), with a higher mortality rate (43.6% in HD vs. 1.8% in controls).

Conclusions:

  • Hematologic disease patients experience significantly prolonged SARS-CoV-2 viral shedding.
  • Longer-term isolation protocols may be necessary for COVID-19 patients with hematologic conditions.
  • Hematologic diseases are associated with increased COVID-19 severity and mortality.

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