No abstract

Coronavirus disease 2019 (COVID-19) has a wide spectrum of clinical presentations, ranging from asymptomatic infection to critical disease requiring intensive care admission and ventilatory support, 1 with a dysregulated immune response, or the cytokine storm, being implicated in the causation of the latter. 2 Determining which part of this spectrum a patient falls in is dependent on a number of factors, amongst which comorbidities, including hematological malignancies, are a major contributor.Available data show variable effects of hematological malignancies on the outcome of patients with COVID-19 based on the disease and the treatment received, including a "protective" effect from severe COVID-19 due to the weakened immune response in some patients. 3 Most of the reports about patients with chronic myeloid leukemia (CML) and COVID-19 described a mild disease course with recovery, 4-10 except for one case report. 11 One possible explanation is the antiviral effect of tyrosine kinase inhibitors (TKIs) through off-target Abl kinase inhibitor which blocks viral entry into host cells, 12 upregulating "antiviral" genes, and decreasing the expression of genes with "proviral" action. 13 In fact, several clinical trials are currently looking into the use of imatinib to treat patients with COVID-19. 14 On the other hand, patients with CML not achieving a complete hematological response, and those in advanced phase disease who did not achieve a complete cytogenetic or a major molecular response had an increased risk of developing COVID-19. 9Herein, we report a case series of nine patients with chronic phase (CP)-CML who had COVID-19 in the period between December 2020 and March 2021 and present their outcomes. All patients had their CML management under the Haematology Department in Northwick Park Hospital, a part of the London North West University Healthcare NHS Trust. COVID-19 diagnosis was confirmed by a positive polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 on a nasopharyngeal swab for all patients. COVID-19 severity was assessed according to National Institute for Health and Care Excellence and World Health Organization guidelines. 15 Patients' data were retrospectively collected from their medical records. Statistical Package for Social Sciences software, version 27 (SPSS; IBM Corp.) was used for statistical analysis.Median and range were used to summarize nonparametric quantitative data. Fisher exact test was used to compare qualitative data, and Mann-Whitney U test to compare medians between groups. A