ABSTRACT
Introduciton: COVID19 is one of the largest pandemics. Since December 2019 until now the coronavirus has infected over 131 million people. The mortality rate in the general population varies between 1 to 5%, with a potential of over 30% in patients with neoplasms. Methods: The main objective of the study was to identify some peculiarities of the evolution, complications and treatment of patients with acute leukaemia and COVID-19. The study was retrospective and included 50 patients with acute leukaemia and COVID-19. Results: Recent administration of chemotherapy was identified in 20 patients with acute myeloblastic leukaemia and 4 patients with acute lymphoblastic leukaemia. The newly diagnosed patients or those undergoing intensive chemotherapy, in particular elderly patients, had a severe form of COVID-19 and an unfavourable evolution, and these clinical situations were identified as predictive factors for adverse outcomes. Patients with acute lymphoblastic leukaemia had a shorter survival curve compared to patients with acute myeloblastic leukaemia. Pneumonia was present especially in patients with acute myeloblastic leukaemia, most patients having over 30% of lung fields affected (55.26%). Patients with an unfavourable outcome had significantly increased median values of C-reactive protein, procalcitonin and interleukin6. Conclusions: Patients with acute leukaemia, especially acute myeloblastic leukaemia who have been diagnosed with COVID-19 infection require special attention because they may associate complications and adverse outcomes of COVID-19. The results we obtained require evaluation in a larger group of patients and analysis in the follow-up period after COVID-19.
ABSTRACT
Background: The severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) was first reported in Wuhan, China in December2019 and represented the pathogen agent that induced COVID-19. The onset and evolution of COVID -19 is severe when is associated with another comorbidities. Patients with acute leukemia present high risk for severe form of COVID-19 Aims: The main objective was to evaluate the particularities of COVID-19 in patients with acute leukemia. Methods: Our study was prospective and included 49 patients with acute leukemia (27 male median age 64 and22 female median age 54,5) who also were SARS CoV2 positive between April2020- February2021 admitted in Hematology and Intensive Care Unit Departments of Colentina Clinical Hospital Bucharest. The diagnosis was established using molecular test for SARS-Cov2 Results: In the group was included 32 patients diagnosed with acute myeloid leukemia (AML), 9 patients with acute lymphoid leukemia (ALL), 6 patients with acut promyelocytic leukemia and2 patients with acute bifenotypic leukemia. Severe form of COVID-19 with ICU addmission was diagnosed in16 patients (32,17%), almost all of them (15 patients) had unfavourable evolution compared with non-ICU patients group with only1 deceased patient, p<0.0001. The recent chemotherapy followed by severe aplasia was the main negative factor that impacted patient evolution (rho=0.508, p=0.0002),13 patients admitted in ICU Department and12 patients in non-ICU. Severe pneumonia (more than 30% lung field) was diagnosed in17 patients with recent chemotherapy and 4 untreated patients. The type of leukemia or refractory status have not any impact of patient evolution. Antiviral therapy - Remdesivir rapidly introduced in patient's therapy was followed by favourable evolution. Summary/Conclusion: Patients with acute leukemia are negatively impacted by intensive chemotherapy during COVID-19 evolution. The key for good prognosis of these patients during COVID-19 are rapid diagnosis and antiviral therapy at the onset of the disease.