IMPACT OF COVID-19 ON OUTCOMES OF PATIENTS WITH HEMATOLOGIC MALIGNANCIES: A MULTI-CENTER, RETROSPECTIVE STUDY COVID-19 and hematologic malignancy

Main Article Content

İbrahim Halil Açar https://orcid.org/0000-0002-8657-1407
Sebnem Izmir Güner https://orcid.org/0000-0002-8332-2966
Muzeyyen Aslaner Ak https://orcid.org/0000-0001-6621-3138
Mesut Gocer https://orcid.org/0000-0002-0346-7154
Erman Ozturk https://orcid.org/0000-0002-1559-8047
Figen Atalay https://orcid.org/0000-0003-4384-2913
Gulden Sincan https://orcid.org/0000-0002-7671-7628
Aysun Senturk Yikilmaz https://orcid.org/0000-0001-5281-5955
Omer Ekinci https://orcid.org/0000-0002-4636-3590
Idris Ince https://orcid.org/0000-0002-1782-5100
Emine Gulturk https://orcid.org/0000-0003-2836-6162
Nazli Demir https://orcid.org/0000-0002-9184-6065
Ali Dogan https://orcid.org/0000-0003-0207-3505
Yildiz Ipek https://orcid.org/0000-0003-2952-2286
Birol Guvenc https://orcid.org/0000-0001-7641-5673

Keywords

Hematologic malignancies, COVID-19 virus disease, mortality

Abstract

Objectives: Patients with hematologic malignancies have a high risk of coronavirus disease 2019 (COVID-19) mortality. This study aimed to investigate the impact of COVID-19 on mortality rates in patients with various hematologic malignancies and to determine risk factors associated with all-cause mortality.


Methods: A multi-center, observational retrospective analysis of patients with hematologic malignancies infected with COVID-19 between July 2020 and December 2021 was performed. Demographic data, clinical characteristics, and laboratory parameters were recorded. Patients were grouped as non-survivors and survivors. All-cause mortality was the primary outcome of the study.


Results: There were 569 patients with a median age of 59 years. Non-Hodgkin lymphoma (22.0%) and multiple myelomas (18.1%) were the two most frequent hematologic malignancies. The all-cause mortality rate was 29.3%. The highest mortality rates were seen in patients with acute myeloid leukemia (44.3%), acute lymphoid leukemia (40.5%), and non-Hodgkin lymphoma (36.8%). The non-survivors were significantly older (p<0.001) and had more comorbidities (p<0.05). There were significantly more patients with low lymphocyte percentage (p<0.001), thrombocytopenia (p<0.001), and high CRP (p<0.001) in the non-survived patients. Cardiac comorbidities, (p=0.016), cytotoxic chemotherapy (p=0.024), low lymphocyte percentage (p=0.025), thrombocytopenia (p<0.0001), and high CRP values (p=0.017) were the independent risk factors for the prediction of mortality.


Conclusions: In patients with hematologic malignancies, coexistent COVID-19 leads to a higher mortality rate in elderly patients with more comorbidities. Acute myeloid and lymphoid leukemia and non-Hodgkin lymphoma have the highest mortality rates. Cardiac diseases, cytotoxic chemotherapy, lymphopenia, thrombocytopenia, and high CRP are the independent risk factors for mortality in hematologic malignancy patients with COVID-19.


Keywords: Covid; Hematologic Malignancy; Cytotoxic chemotherapy.

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