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There is limited evidence on various clinical aspects of SARS-CoV-2 infection in patients with haematological cancers. The risk factors, prognosis, and outcome of patients with haematological cancers with coexistent COVID-19 need to be explored in different subsets of population. A single-institutional prospective observational study was conducted at a tertiary level medical institute in North India. The clinical details of the recruited patients having haematological malignancies and diagnosed with COVID-19 between 15 March 2020 and 31 May 2021 were prospectively collected through the electronic patient database system. The outcomes with respect to 28-day and 56-day mortality and the associated risk factors for prognostication were analysed. Of the 5750 hospital admissions (inpatient and day-care) during the study period, two hundred and forty-two patients (4.2%) were diagnosed with COVID-19. Acute leukaemia was the most common haematological malignancy, seen in 117 (48.3%) patients. Eighty-nine (36.8%) patients had moderate-to-severe COVID-19 while 153 (63.2%) patients presented with mild infection. The 28-day and 56-day mortality rates in our cohort were 13.3% and 19.8% respectively. Amongst the risk factors associated with poor outcome, the severity of COVID-19 (HR = 1.8, 95% CI 1.16–10.35; p = 0.04), presence of secondary infection (HR = 2.1, 95% CI 2.45–21.3; p = 0.023), and need for invasive mechanical ventilation (HR = 2.3, 95% CI 1.8–18.43; p = 0.01) were prognostically significant on multivariate log rank analysis. The risk of SARS-CoV-2 infection does not increase with haematological malignancies; however, the outcome remains poor in patients with severe COVID-19, requirement of invasive mechanical ventilation, and pre-existing bacterial/fungal infection at presentation.

Validity of naked eye single tube red cell osmotic fragility test ('Nestroft') was evaluated on 253 individuals divided into two groups. The HbA2 values estimated in each child was taken as gold standard. Group I comprised of 93 individuals belonging to families in which at least one of the children was suffering from beta-thalassemia major and group II consisted of 160 normal children. The sensitivity of 'Nestroft' was 95.59 per cent (grp I) & 85.71 per cent (grp II), specificity was 84.2 per cent (grp I) and 81.7 per cent (grp II) with a negative predictive value as high as 99.21 per cent in general population. The results of the test were assessed by two independent observers and P values of 0.75 and 0.69 were found in grp I and grp II, respectively. The values clearly showed that the interobserver variation was statistically insignificant thus proving it to be an objective test. Comparative analysis of 'nestroft' with red cell indices, i.e. MCV (< 70 fi) and RBC count (> 4.5 x 10(12)/l) revealed it to be the most sensitive and specific test. 'Nestroft' has emerged as the single most effective, inexpensive and easily reproducible test of population screening for beta-thalassemia trait.