Predictors of adverse COVID-19 outcomes in patients with oncohematological diseases

Abstract

Material and methods. We performed a prospective cohort study including 66 patients with oncohematological pathology and confirmed COVID-19 infection who underwent treatment at the SI “Minsk Scientific and Practical Center for Surgery, Transplantology and Hematology” from March to September 2020.Results. The overwhelming majority of patients with hematological pathology and COVID-19 infection were diagnosed with multiple myeloma (MM) — 25 (37.8 %). The highest mortality rate was recorded in patients with multiple myeloma and acute leukemia (21 % and 12 %, respectively). Stage 4–5 chronic kidney disease (p<0.05, Fisher’s exact test; 0.01) is a statistically significant factor of adverse outcomes in patients with oncohematological diseases. The presence of coronary artery disease, diabetes mellitus or other pathology did not affect the outcome. We found no effect of previous polychemotherapy performed within the time of less than a month (HR 1.15; 95 % CI 0.66–2.0) and less than 3 months (HR 0.94 %; 95% CI 0.53–1.65) on the risk of the fatal outcome of the infection in patients with neoplastic diseases of hematopoietic tissue. Age over 60 (HR 1.8; 95 % CI 1.01-3.28) and the stage of progression according to the underlying disease (HR 2.8; 95 % CI 1.9–4.0) were statistically significant factors of the fatal outcome in patients with oncohematological diseases.Conclusion. The presented study has determined the predictors of the fatal outcome in COVID-19 patients with oncohematological diseases: age over 60 and the stage of progression of the underlying disease. At the same time, the highest mortality rate in COVID-19 was recorded in patients with multiple myeloma and acute leukemia (21 % and 12 %, respectively). Among all the analyzed comorbidity factors, stage 4–5 chronic kidney disease had a statistical significance for adverse outcomes.