COVID-19 in Patients with Hematologic Disorders Undergoing Therapy: Perspective of a Large Referral Hematology Center in Rome

Abstract

Introduction: Patients with cancer may be more susceptible to and have higher morbidity and mortality rates from COVID-19 than the general population, while epidemiologic data specifically addressed to hematologic patients are limited. To investigate whether patients with hematologic diseases undergoing therapy are at increased risk for acquiring SARS CoV-2 infection compared to the general population, a retrospective study was carried out at a referral hematologic center in Rome, Italy, during the period of the greatest epidemic spread (March 8 to May 14, 2020). Methods: All adult and pediatric patients with a diagnosis of a neoplastic or a nonneoplastic hematologic disease who underwent treatment (chemotherapy or immunosuppressive or supportive therapy) during the study period or in the previous 6 months were considered. The prevalence of COVID-19 in the overall outpatient and inpatient population undergoing hematologic treatment compared to that of the general population was analyzed. The measures taken to manage patients during the epidemic period are described. Results: Overall, 2,513 patients with hematological diseases were considered. Out of 243 (9.7%) patients who were screened for SARS CoV-2, three of 119 (2.5%) outpatients with fever or respiratory symptoms and none of 124 asymptomatic patients were diagnosed with COVID-19. Three further patients were diagnosed with COVID-19 and managed in other hospitals in Rome. As of May 14, 2020, the prevalence of COVID-19 in our hematologic population accounted for 0.24% (95% CI 0.23–0.25; 6 of 2,513 patients: 1 case in every 419 patients) as compared to 0.12% (7,280 of 5,879,082 residents; 1 case in every 807 residents) in the general population (p = 0.14). Three of 6 patients diagnosed with COVID-19 required critical care and 2 died while still positive for SARS CoV-2. Out of 225 healthcare providers on duty at our Institution during the study period, 2 (0.9%) symptomatic cases were diagnosed with COVID-19. Conclusion: In our experience, the prevalence of COVID-19 in hematologic patients, mainly affected by malignancies, was not significantly higher compared to that of the general population. Definition of adapted strategies for healthcare services, while continuing to administer the standard hematologic treatments, represents the crucial challenge for the management of hematologic diseases in the COVID-19 era.

COVID-19 in 96 Patients With Hematologic Disease: The First Single-center Experience From the Czech Republic

“…The authors present their own experiences with treating patients with hematologic diseases and COVID-19 infection obtained in a single center for specialized hematology care in the Czech Republic in 2020. In a study by Girmenia et al, 13 the prevalence of COVID-19 among patients with hematologic diseases (including nonmalignancies) was 0.24%, as compared with only 0.12% in the general population ( P = .14). Other studies reported prevalence rates of 0.17% to 0.9%, depending on the type of hematologic malignancy.…”

Impact of Comorbidities on Outcome in Children With COVID-19 at a Tertiary Care Pediatric Hospital

“…There is a dearth of published literature on outcome of SARS-CoV-2 infected children with various comorbidities [8][9][10][11]. Three children with disseminated tuberculosis developed acute respiratory distress syndrome (ARDS) and multi-organ failure syndrome (MODS), and one died due to raised intracranial tension with neurogenic shock.…”

Reduced transmission of Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) in patients with haematological malignancies hospitalized in an Italian hospital during the COVID-19 pandemic

“…Consequently, planned activities were suspended, except for non-deferrable treatments, including those for patients with haematological malignancies. 2 …”