Subject(s)
BNT162 Vaccine/administration & dosage , COVID-19/immunology , ChAdOx1 nCoV-19/administration & dosage , Monoclonal Gammopathy of Undetermined Significance/immunology , SARS-CoV-2/immunology , Smoldering Multiple Myeloma/immunology , Vaccination , Aged , Antibodies, Viral , BNT162 Vaccine/immunology , COVID-19/prevention & control , ChAdOx1 nCoV-19/immunology , Female , Humans , MaleSubject(s)
COVID-19/complications , Multiple Myeloma/complications , Adult , Aged , Aged, 80 and over , Antibody Formation , COVID-19/diagnosis , COVID-19/immunology , COVID-19/therapy , COVID-19 Testing , COVID-19 Vaccines/therapeutic use , Female , Humans , Immunomodulation , Male , Middle Aged , Multiple Myeloma/immunology , Multiple Myeloma/therapy , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purificationABSTRACT
Haematology patients receiving chemo- or immunotherapy are considered to be at greater risk of COVID-19-related morbidity and mortality. We aimed to identify risk factors for COVID-19 severity and assess outcomes in patients where COVID-19 complicated the treatment of their haematological disorder. A retrospective cohort study was conducted in 55 patients with haematological disorders and COVID-19, including 52 with malignancy, two with bone marrow failure and one immune-mediated thrombotic thrombocytopenic purpura (TTP). COVID-19 diagnosis coincided with a new diagnosis of a haematological malignancy in four patients. Among patients, 82% were on systemic anti-cancer therapy (SACT) at the time of COVID-19 diagnosis. Of hospitalised patients, 37% (19/51) died while all four outpatients recovered. Risk factors for severe disease or mortality were similar to those in other published cohorts. Raised C-reactive protein at diagnosis predicted an aggressive clinical course. The majority of patients recovered from COVID-19, despite receiving recent SACT. This suggests that SACT, where urgent, should be administered despite intercurrent COVID-19 infection, which should be managed according to standard pathways. Delay or modification of therapy should be considered on an individual basis. Long-term follow-up studies in larger patient cohorts are required to assess the efficacy of treatment strategies employed during the pandemic.