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COVID-19 severity and survival over time in patients with hematologic malignancies: a population-based registry study

Autores: Martínez-López, J.; de la Cruz, J. (Autor de correspondencia); Gil-Manso, R.; Alegre, A.; Ortiz, J.; Llamas, P.; Martínez, Y.; Hernández-Rivas, J. Á.; González-Gascón, I.; Benavente, C.; Estival-Monteliu, P.; Jiménez-Yuste, V.; Canales Albendea, Miguel Angel; Bastos, M.; Kwon, M.; Valenciano, S.; Callejas-Charavia, M.; López-Jiménez, J.; Herrera, P.; Duarte, R.; Núñez-Martín Buitrago, L.; Sánchez-Godoy, P.; Jacome-Yerovi, C.; Martínez-Barranco, P.; García-Roa, M.; Escolano-Escobar, C.; Matilla, A.; Rosado-Sierra, B.; Aláez-Uson, M. C.; Quiroz-Cervantes, K.; Martínez-Chamorro, C.; Pérez-Oteyza, J.; Martos-Martínez, R.; Herráez, R.; González-Santillana, C.; del Campo, J. F.; Alonso, A.; de la Fuente, A.; Pascual, A.; Bustelos-Rodríguez, R.; Sebrango, A.; Ruiz, E.; Marcheco-Pupo, E. A.; Grande García, Carlos; Cedillo, Á.; Lumbreras, C.; Arroyo-Barea, A.; Casas-Rojo, J. M.; Calbacho, M.; Diez-Martín, J. L.
Título de la revista: CANCERS
ISSN: 2072-6694
Volumen: 15
Número: 5
Páginas: 1497
Fecha de publicación: 2023
Simple Summary There are contradictory data about coronavirus disease (COVID-19) in patients with hematological malignancies. In this population-based study we evaluated severity and survival of unvaccinated patients with hematological malignancies (HM) and COVID-19 in the Madrid region, Spain, between early February 2020 and February 2021. Also, a comparison was made with non-cancer patients from the SEMI-COVID registry and post COVID-19 conditions were evaluated. Overall, 30-day mortality was 32.7%, with higher mortality among certain groups of patients (aged >= 60 years, presence of >= 3 comorbidities, diagnosis of AML/ALL, treatment with conventional chemotherapy within 30 days of COVID-19 diagnosis, recipients of systemic corticosteroids as COVID-19 therapy). Mortality rates were similar between earlier and later phases of the pandemic, not paralleling the reduction of mortality in non-cancer patients. Up to 27.3% patients had a post COVID-19 condition. These findings will be useful to understand COVID-19 morbidity and mortality in unvaccinated patients diagnosed with HM. Mortality rates for COVID-19 have declined over time in the general population, but data in patients with hematologic malignancies are contradictory. We identified independent prognostic factors for COVID-19 severity and survival in unvaccinated patients with hematologic malignancies, compared mortality rates over time and versus non-cancer inpatients, and investigated post COVID-19 condition. Data were analyzed from 1166 consecutive, eligible patients with hematologic malignancies from the population-based HEMATO-MADRID registry, Spain, with COVID-19 prior to vaccination roll-out, stratified into early (February-June 2020; n = 769 (66%)) and later (July 2020-February 2021; n = 397 (34%)) cohorts. Propensity-score matched non-cancer patients were identified from the SEMI-COVID registry. A lower proportion of patients were hospitalized in the later waves (54.2%) compared to the earlier (88.6%), OR 0.15, 95%CI 0.11-0.20. The proportion of hospitalized patients admitted to the ICU was higher in the later cohort (103/215, 47.9%) compared with the early cohort (170/681, 25.0%, 2.77; 2.01-3.82). The reduced 30-day mortality between early and later cohorts of non-cancer inpatients (29.6% vs. 12.6%, OR 0.34; 0.22-0.53) was not paralleled in inpatients with hematologic malignancies (32.3% vs. 34.8%, OR 1.12; 0.81-1.5). Among evaluable patients, 27.3% had post COVID-19 condition. These findings will help inform evidence-based preventive and therapeutic strategies for patients with hematologic malignancies and COVID-19 diagnosis.