Abstract
Initial studies that described the novel coronavirus (COVID-19) reported increased morbidity and mortality in patients with cancer. Of this group, patients with hematologic malignancies (HM) had the highest disease severity and death rates. Subsequent studies have attempted to better describe how COVID-19 affects patients with HM. However, these studies have yielded variable and often contradictory results. We present our single-institution experience with patients with HM who were diagnosed with COVID-19 from March 2020 to March 2021. We report 62 total cases with 10 patients who died during this time. The overall mortality was 16.1%. Mortality during the first two waves of COVID was 27.8% and 25%. Mortality during the third wave of COVID was 10%. The median age of patients was 67 years (range 20-89 years). 55% of patients had lymphoid malignancies and the majority had active disease at the time of diagnosis with COVID-19. 87% of patients had more than one co-morbidity. Important co-morbidities included cardiovascular disease and smoking history. 38.7% of patients had asymptomatic or mild disease, 54.8% required hospitalization, and 17.5% required ICU level care. In patients who required ICU level care, the mortality was 60%.
Highlights
The novel coronavirus (COVID-19) was first discovered in Wuhan, China in December 2019 and quickly escalated to a global pandemic
Most patients had active disease and 38% of all patients were on active treatment at the time of COVID-19 diagnosis. 38.7% of patients had mild or asymptomatic disease that did not require hospitalization. 54.8% of patients required hospital admission and 17.7% of patients had severe disease requiring ICU-level care
In contrast to the published experience, we found that the number of confirmed COVID-19 in patients with hematologic malignancies (HM) at our center was surprisingly low, with only 62 cases in 12 months
Summary
The novel coronavirus (COVID-19) was first discovered in Wuhan, China in December 2019 and quickly escalated to a global pandemic. Patients with cancer have increased contact with the healthcare system and, as a result, are at an increased risk of COVID-19 infection. Initial studies in China showed that the frequency of severe COVID-19 infection (ICU admission, requiring invasive ventilation) and death was higher in patients with cancer compared to the general population [2]. Later studies suggested that patients with HM are especially vulnerable and were found to have highest disease severity and death rates among all patients with cancer [3]. This may be, in part, because patients with HM often have innate and adaptive immune dysfunction [4]. Some studies have suggested that systemic therapy at the time of COVID-19 infection could correlate with milder symptoms due to an attenuated inflammatory response [7, 8]
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