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Francesco Marchesi; Jon Salmanton-Garcia; Ziad EMARAH; Klára PIUKOVICS; Marcio Nucci; Alberto Lopez-Garcia; Zdenek Racil; Francesca Farina; Marina POPOVA; Sofia ZOMPI; Ernesta Audisio; Marie-Pierre Ledoux; Luisa VERGA; Barbora Weinbergerova; Tomas Szotkowski; Maria Silva; Nicola Stefano Fracchiolla; Nick DE JONGE; Graham Collins; Monia Marchetti; Gabriele MAGLIANO; Carolina GARCÍA-VIDAL; Monika M. BIERNAT; Jaap van Doesum; Marina MACHADO; Fatih Demirkan; Murtadha Al Khabori; Pavel Zak; Benjamin Visek; Igor STOMA; Gustavo-Adolfo MÉNDEZ; Johan Maertens; Nina KHANNA; Ildefonso Espigado; Giulia DRAGONETTI; Luana Fianchi; Maria Ilaria Del Principe; Alba CABIRTA; Irati ORMAZABAL-VÉLEZ; Ozren Jaksic; Caterina BUQUICCHIO; Valentina BONUOMO; Josip Batinić; Ali S. OMRANI; Sylvain Lamure; Olimpia Finizio; Noemí FERNÁNDEZ; Iker FALCES-ROMERO; Ola BLENNOW; Rui BERGANTIM; Natasha Ali; Sein WIN; Jens VAN PRAET; Maria Chiara Tisi; Ayten SHIRINOVA; Martin SCHÖNLEIN; Juergen PRATTES; Monica PIEDIMONTE; Verena Petzer; Milan NAVRÁTIL; Austin Kulasekararaj; Pavel Jindra; Jiří SRAMEK; Andreas Glenthøj; Rita FAZZI; Cristina de Ramón; Chiara Cattaneo; Maria CALBACHO; Nathan C. BAHR; Shaimaa Saber EL-ASHWL; Raúl Córdoba; Michaela HANAKOVA; Giovanni ZAMBROTTA; Mariarita Sciumè; Stephen Booth; Raquel NUNES-RODRIGUES; Maria Vittoria SACCHI; Nicole GARCÍA-POUTÓN; Juan-Alberto MARTÍN-GONZÁLEZ; Sofya KHOSTELIDI; Stefanie GRÄFE; Laman RAHIMLI; alessandro busca; Paolo Corradini; Martin HOENIGL; Nikolai KLIMKO; Philipp Koehler; Antonio PAGLIUCA; Francesco Passamonti; Oliver Cornely; Livio pagano.
researchsquare; 2022.
Preprint in English | PREPRINT-RESEARCHSQUARE | ID: ppzbmed-10.21203.rs.3.rs-1323457.v1

ABSTRACT

Patients with acute myeloid leukemia (AML) are at high risk of mortality from coronavirus disease 2019 (COVID-19). The optimal management of AML patients with COVID-19 has not been established. Our multicenter study included 388 adult AML patients with COVID-19 diagnosis between February 2020 and October 2021. The vast majority were receiving or had received AML treatment in the prior 3 months. COVID-19 was severe in 41.2% and critical in 21.1% of cases. The chemotherapeutic schedule was modified in 174 patients (44.8%), delayed in 68 and permanently discontinued in 106. After a median follow-up of 325 days, 180 patients (46.4%) had died. Death was attributed to COVID-19 (43.3%), AML (26.1%) or to a combination of both (26.7%). Active disease, older age, and treatment discontinuation were associated with death, whereas AML treatment delay was protective. Seventy-nine patients had a simultaneous AML and COVID-19 diagnosis, with an improved survival when AML treatment could be delayed. Patients with COVID-19 diagnosis between January and August 2020 had a significantly lower survival. COVID-19 in AML patients was associated with a high mortality rate and modifications of therapeutic algorithms. The best approach to improve survival was to delay AML treatment.


Subject(s)
COVID-19
2.
medrxiv; 2020.
Preprint in English | medRxiv | ID: ppzbmed-10.1101.2020.06.05.20113738

ABSTRACT

Background In some patients the immune response triggered by SARS-CoV-2 is unbalanced, presenting an acute respiratory distress syndrome which in many cases requires intensive care unit (ICU) admission. The limitation of ICU beds has been one of the major burdens in the management around the world, therefore, clinical strategies to avoid ICU admission are needed. Objective We aimed to describe the influence of tocilizumab on the need of transfer to ICU or death in non-critically ill patients. Methods A retrospective study of 171 patients with SARS-CoV-2 infection that did not qualify as requiring transfer to ICU during the first 24h after admission to a conventional ward, were included. The criteria to receive tocilizumab was radiological impairment, oxygen demand or an increasing of inflammatory parameters, however, the ultimate decision was left to the attending physician judgement. The primary outcome was the need of ICU admission or death whichever came first. Results 77 patients received tocilizumab and 94 did not. The tocilizumab group had less ICU admissions (10.3% vs. 27.6%, P= 0.005) and need of invasive ventilation (0 vs 13.8%, P=0.001). In the multivariable analysis, tocilizumab remained as a protective variable (OR: 0.03, CI 95%: 0.007-0*1, P=0.0001) of ICU admission or death. Conclusions Tocilizumab in the early stages of the inflammatory flare, could avoid an important number of ICU admissions and mechanical ventilation use. The mortality rate of 10.3% among patients receiving tocilizumab appears to be lower than other reports.


Subject(s)
COVID-19 , Death , Respiratory Distress Syndrome
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