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Published on: March 22, 2012
COVID-19 infection in patients with haematological disease - A tertiary centre experience from north India
Mukul Aggarwal1, Mirza Saleem Amjad1, Akash Khandelwal1
1Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.
Insights
Patients with hematological diseases, especially malignancies and aplastic anemia, faced higher COVID-19 severity and mortality risks. Moderate to severe COVID-19 was a significant predictor of death in this vulnerable group.
Area of Science:
- Hematology
- Infectious Diseases
- Oncology
Background:
- The clinical course and outcomes of COVID-19 in patients with underlying hematological diseases are not well-defined.
- Hematological malignancies and benign disorders may predispose individuals to severe COVID-19 infection.
Purpose of the Study:
- To investigate the clinical, laboratory, radiological parameters, and outcomes of COVID-19 patients with hematological diseases.
- To identify risk factors for mortality in this patient cohort.
Main Methods:
- Retrospective analysis of medical records of COVID-19 positive patients with known hematological diseases admitted between April and August 2020.
- Data collected included demographics, hematological diagnosis, COVID-19 severity, symptoms, and treatment, with a focus on outcomes and mortality.
Main Results:
- Fifty-four patients were included: 36 with hematological malignancy and 18 with benign disorders. Common symptoms were fever, cough, and dyspnea.
- Overall mortality was 37.0%, with higher rates in aplastic anemia (50.0%), acute myeloid leukemia (46.7%), and acute lymphoblastic leukemia (40.0%).
- Multivariate analysis identified moderate to severe COVID-19 as a significant predictor of mortality (OR 16.6).
Conclusions:
- Patients with hematological malignancies and aplastic anemia are at increased risk for severe COVID-19 infection and mortality.
- COVID-19 severity is a critical determinant of mortality in patients with hematological conditions.
Abstract:
This retrospective study was aimed to understand the clinical, laboratory, radiological parameters and the outcome of COVID-19 patients with underlying haematological disease. All patients with known haematological disease admitted with COVID-19-positive status from April to August 2020 in the COVID-19 facility of a tertiary care centre in north India, were included. Their medical records were analyzed for outcome and mortality risk factors. Fifty four patients, 37 males, were included in the study. Of these, 36 patients had haematological malignancy and 18 had benign disorder. Fever (95.5%), cough (59.2%) and dyspnoea (31.4%) were the most common symptoms. Nine patients had severe disease at diagnosis, mostly malignant disorders. Overall mortality rate was 37.0 per cent, with high mortality seen in patients with aplastic anaemia (50.0%), acute myeloid (46.7%) and lymphoblastic leukaemia (40.0%). On univariate analysis, Eastern Cooperative Oncology Group performance status >2 [odd ratio (OR) 11.6], COVID-19 severity (OR 8.2), dyspnoea (OR 5.7) and blood product transfusion (OR 6.4) were the predictors of mortality. However, the presence of moderate or severe COVID-19 (OR 16.6, confidence interval 3.8-72.8) was found significant on multivariate analysis. The results showed that patients with haematological malignancies and aplastic anaemia might be at increased risk of getting severe COVID-19 infection and mortality as compared to the general population.
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