Effect of age, comorbidity and remission status on outcome of COVID-19 in patients with hematological malignancies

Borah, Pronamee; Mirgh, Sumeet; Sharma, Sanjeev; Bansal, Sachin; Dixit, Ashish; Dolai, Tuphan Kanti; Lunkad, Sweta; Gupta, Naveen; Singh, Gurmeet; Jain, Anjali; Bansal, Divya; Choudhary, Deepak; Khandelwal, Vipin; Doval, Divya; Kumar, Meet; Bhargava, Rahul; Chakrabarti, Amrita; Kalashetty, Mallikarjun; Rauthan, Amit; Kazi, Bilal; Mandal, Prakas Kumar; Jeyaraman, Preethi; Naithani, Rahul

doi:10.1016/j.bcmd.2020.102525

Cited by 39 publications

(54 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This could be one of the reasons for high mortality in our study. Adverse effect of age and comorbidity in patients with haematological malignancy was previously demonstrated by our group [21].…”

Section: Discussionsupporting

confidence: 58%

“…This study revealed an increased risk of need for ICU admission, mechanical ventilation and death compared with Covid-19 patients without cancer [20]. We have earlier documented a high 60% mortality rate in patients with hematological malignancies with severe Covid-19 [21]. Mortality in present study with use of CPT is 45.5%.…”

Section: Discussionsupporting

confidence: 48%

“…This has not been reported in literature. Covid-19 related mortality in elderly patients and/or patients with co-morbidities can be 15% higher than in general younger population [19,21,24]. The median age of patients included in our study was 62 years and > 60% of patients were above the age of 60 years.…”

Section: Discussionmentioning

confidence: 77%

“…Mortality in present study with use of CPT is 45.5%. This difference may be due to benefit of CPT or could be due to present study being limited to 4 larger centres with better infrastructure to manage Covid-19 complications compared to previous study which was spread-out in 11 centres across India [21]. Lack of control arm in present study makes it difficult to evaluate efficacy of CPT in this group.…”

Section: Discussionmentioning

confidence: 81%

See 3 more Smart Citations

Convalescent plasma therapy for severe Covid-19 in patients with hematological malignancies

Jeyaraman

Agrawal

Bhargava

et al. 2021

Transfusion and Apheresis Science

Self Cite

View full text Add to dashboard Cite

Background Data on convalescent plasma therapy (CPT) in patients of hematological malignancies with severe Covid-19 is scarce. Objective To study 14-day mortality in patients who received CPT. Patients & Methods Retrospective multicentre observational study conducted in 4 centres treating haematological malignancies across Delhi-national capital region. Total 33 haematological malignancies patients with severe Covid-19 who received CPT were analysed. Results The median age of the study cohort was 62 years (18 to 80 years). Twenty one percent patients had 1 comorbidity, 18% had 2 comorbidities and 6% patients had 3 and 5 comorbidities each. Twenty four patients were on active therapy. Sixty nine percent of patients required ICU stay. Twenty five patients received plasma therapy within 7 days (early) of diagnosis of Covid-19 infection. Median day of plasma infusion from date of diagnosis of Covid-19 infection was 4 days (range: 2 to 25 days). Patient who had early initiation of plasma therapy had shorter duration of hospitalisation (12.7 vs 24.3 days, p = 0.000). Overall mortality in the cohort was 45.5%. There was no effect of disease status, active therapy, presence of comorbidity on mortality. There was no difference in the mortality in patients receiving early vs late initiation of plasma therapy or in patients receiving one versus two plasma therapy. Conclusions We provide a large series of patients with hematological malignancies and role of CPT in this group.

show abstract

Section: Discussionsupporting

confidence: 58%

Section: Discussionsupporting

confidence: 48%

Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 81%

See 2 more Smart Citations

Convalescent plasma therapy for severe Covid-19 in patients with hematological malignancies

Jeyaraman

Agrawal

Bhargava

et al. 2021

Transfusion and Apheresis Science

Self Cite

View full text Add to dashboard Cite

show abstract

“…All patients with diabetes mellitus, chronic kidney disease and hyperthyroidism died (Fig. 3), probably due to, the instability in the general state of health that was confirmed by COVID-19 [15,13].…”

Section: Resultsmentioning

confidence: 92%

Survival in Patients with Acute Lymphoblastic Leukemia and COVID-19 in Mexico

Martinez

Flores

Vidal³

2021

IBRR

View full text Add to dashboard Cite

Aims: To determine the survival of patients with acute lymphoblastic leukemia and COVID-19. Study Design: Prospective, analytical and relational. Place and Duration of Study: Hematology department, Hospital of Specialties, High Specialty Medical Unit, National Medical Center "Gral. Manuel Avila Camacho", Puebla, Mexico, during the period June 2020-April 2021 Methodology: Patients aged 15 to 64 years, both sexes, with acute lymphoblastic leukemia and a confirmed diagnosis of COVID-19 by PCR. The variables included were; sex, age (groups: 15-20; 21-29; 30-39; 40-49; 50-59; and 60-64), comorbidities, general treatment and hematological treatment response. Survival was determined for the diagnosis of COVID-19 for 11 months, using the Kaplan Meier estimator and the Log-Rak test; Cox regression model (univariate and multivariate); as well as Chi square and V-Cramer with a 95% confidence interval and using the statistical program SPSS Ver. 25. Results: The study consisted of 20 patients, of which 33.3% were women, with an average age of 37.75 ± 11.63 years; The men registered an age of 28.50 ± 18.05 years. Overall survival was 50%, with a lower limit of 101.3 and an upper limit of 242.5 days, with a mean of 171.9 days; and median at 17 days. No significant differences were found in survival regarding sex, comorbidities, general treatment and hematological response. However, mortality in patients with comorbidities was higher (p = 0.051). Conclusion: Survival in patients with acute lymphoblastic leukemia and COVID-19 is low, due to complications that increase mortality, mainly owing to hematological suppression, and even more so with the presence of comorbidities.

show abstract

Clinical characteristics, laboratory parameters and outcomes of COVID‐19 in cancer and non‐cancer patients from a tertiary Cancer Centre in India

et al. 2021

View full text Add to dashboard Cite

Background There is paucity of data regarding clinical characteristics, laboratory parameters and outcomes of coronavirus disease (COVID‐19) in cancer versus non‐cancer patients, particularly from India. Materials and Methods This was an observational, single‐centre, retrospective analysis of patients with laboratory‐confirmed COVID‐19 hospitalised in our institution between 22 May 2020 and 1 December 2020. We compared baseline clinical characteristics, laboratory parameters and outcomes of COVID‐19 (overall mortality, time to discharge) between cancer and non‐cancer patients. Results A total of 200 COVID‐19 infection episodes were analysed of which 109 (54.5%) were patients with cancer and 91 (45.5%) were patients without cancer. The median age was 43 (interquartile range [IQR]:32–57), 51 (IQR: 33–62) and 38 (IQR: 31.5–49.3) years; of whole cohort, cancer and non‐cancer patients, respectively. Comparison of outcomes showed that oxygen requirement (31.2% [95% CI: 22.6–40.7] vs. 17.6% [95% CI: 10.4–26.9]; p = 0.03), median time to discharge (11 days [IQR: 6.75–16] vs. 6 days [IQR: 3–9.75]; p < 0.001) and mortality (10.0% [95% CI: 5.2–17.3] vs. 1.1% [95% CI: 0.03–5.9]; p = 0.017) were significantly higher in patients with cancer. In univariable analysis, factors associated with higher mortality in the whole cohort included diagnosis of cancer (10.1% vs. 1.1%; p = 0.027; odds ratio [OR]: 7.04), age ≥60 (17.4% vs. 2.6%; p = 0.001; OR: 7.38), oxygen requirement (22% vs. 0.6%; p < 0.001; OR: 29.01), chest infiltrates (19.2% vs. 1.4%; p < 0.001; OR: 22.65), baseline absolute lymphocyte count <1 × 10 9 /L (10.8% vs. 1.9%; p = 0.023; OR:5.1), C‐reactive protein >1 mg% (12.8% vs. 0%; p = 0.027; OR: 24.69), serum procalcitonin >0.05 ng/ml (22.65% vs. 0%; p = 0.004; OR: 4.49) and interleukin‐6 >6 pg/ml (10.8% vs. 1.3%; p = 0.036; OR: 3.08). In multivariable logistic regression, factors significantly associated with mortality were oxygen requirement ( p = 0.005; OR: 13.11) and high baseline procalcitonin level ( p = 0.014; OR: 37.6). Conclusion Cancer patients with COVID‐19 have higher mortality and require longer hospital stay. High procalcitonin levels and oxygen requirement during admission are other factors that affect outcomes adversely.

show abstract

Effect of age, comorbidity and remission status on outcome of COVID-19 in patients with hematological malignancies

Cited by 39 publications

References 25 publications

Convalescent plasma therapy for severe Covid-19 in patients with hematological malignancies

Convalescent plasma therapy for severe Covid-19 in patients with hematological malignancies

Survival in Patients with Acute Lymphoblastic Leukemia and COVID-19 in Mexico

Clinical characteristics, laboratory parameters and outcomes of COVID‐19 in cancer and non‐cancer patients from a tertiary Cancer Centre in India

Contact Info

Product

Resources

About