Multicenter cohort study of the risk factors and mortality of Omicron variant SARS-CoV-2-infected patients with hematologic malignancies in hospitals (preprint)

Purpose Evaluating risk factors of mortality and characters in patients with hematologic malignancy (HM) after anti–severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) vaccination of China.Methods A total of 104 HMs were included with a median follow-up of 45 days.Results The overall mortality rate was 9.6%. In multivariable analyses, 1 or more comorbidities (P = 0.014), lactic dehydrogenase > 300 u/l (P = 0.014), albumin < 35 g/l (P = 0.017) and active malignancy (P = 0.009) were associated with severe and critical COVID-19. Conversely, patients who received 3 vaccinations had a lower possibility of severe infection (P = 0.022). Active malignancy and lactic dehydrogenase > 300 u/l were risk factors associated with higher mortality in multivariable analyses (P = 0.03; P = 0.038, respectively). We also found that the duration of a positive SARS-CoV-2 PCR test and the time to stable pneumonia by chest computed tomography scan in the severe and critical infection subgroups were significantly longer than those in the moderate infection group (P = 0.03 and P = 0.002, respectively).Conclusions These findings may contribute to guiding the management of HMs during the pandemic, and emphasizing the importance of starting treatment of aggressive HMs for earlier remission.

Comparative Study of Hematological and Radiological Feature of Severe/Critically Ill Patients with COVID-19, Influenza A H7N9 and H1N1 Pneumonia (preprint)

Objectives This study aimed to explore useful clinical indexes for management of severe/critically ill patients with COVID-19, Influenza A H7N9 and H1N1 pneumonia by comparing hematological and radiological characteristics between them. Methods Severe/critically ill patients with confirmed diagnosis of COVID-19, Influenza A H7N9 and H1N1 pneumonia were retrospectively enrolled. The demographic data, clinical manifestations, hematological parameters, and radiological characteristics of three groups were compared. The influenza A was divided into two groups with/without patient death.Results In this study, 16 cases of COVID-19, 10 cases of influenza A (H7N9), and 13 cases of influenza A (H1N1) who met severe/critically ill criteria were included. Compared with COVID-19, the Influenza A (H7N9 and H1N1) groups had relatively more chronic diseases (80% and 92.3% vs 25%, P＜0.05), higher APACHE Ⅱ scores (16.00 ± 8.63 and 15.08 ± 6.24, vs 5.50 ± 2.58, P＜0.05) and higher mortality rates (40% and 46.2% vs 0%, P＜0.05). The hematological finding indicated that Influenza A H7N9 and H1N1 patients had more significant lymphocytopenia (0.59 ± 0.31 × 109/L and 0.56 ± 0.35 × 109/L vs 0.97 ± 0.33 × 109/L, P < 0.05), elevated neutrophil to lymphocyte ratio (NLR; 14.67 ± 6.10 and 14.64 ± 10.36 vs 6.29 ± 3.72, P < 0.05) compared to COVID-19. Especially in influenza A patients, NLR was significant different between the patients with or without death. Compared with the H7N9 group, ground glass opacity (GGO) on chest CT was more common in the COVID-19 group (P = 0.028), while pleural effusion was relatively rare (P = 0.001).ConclusionCompared to COVID-19, patients with Influenza A (H7N9 and H1N1) had more underlying chronic diseases and higher mortality rates. The NLR can be used as a clinical parameter for the predication of risk stratification and outcome in COVID-19 and Influenza A pneumonia. Manifestations of pleural effusion or GGO in chest CT may be helpful for the identification of different viral pneumonia.

Comparative study of hematological and radiological feature of severe/critically ill patients with COVID-19, Influenza A H7N9 and H1N1 pneumonia (preprint)

Objectives This study aimed to explore useful clinical indexes for management of severe/critically ill patients with COVID-19, Influenza A H7N9 and H1N1 pneumonia by comparing hematological and radiological characteristics between them.Methods Severe/critically ill patients with confirmed diagnosis of COVID-19, Influenza A H7N9 and H1N1 pneumonia were retrospectively enrolled. The demographic data, clinical manifestations, hematological parameters, and radiological characteristics of three groups were compared. The influenza A was divided into two groups with/without patient death.Results In this study, 16 cases of COVID-19, 10 cases of influenza A (H7N9), and 13 cases of influenza A (H1N1) who met severe/critically ill criteria were included. Compared with COVID-19, the Influenza A (H7N9 and H1N1) groups had relatively more chronic diseases (80% and 92.3% vs 25%, P༜0.05), higher APACHE Ⅱ scores (16.00 ± 8.63 and 15.08 ± 6.24, vs 5.50 ± 2.58, P༜0.05) and higher mortality rates (40% and 46.2% vs 0%, P༜0.05). The hematological finding indicated that Influenza A H7N9 and H1N1 patients had more significant lymphocytopenia (0.59 ± 0.31 × 109/L and 0.56 ± 0.35 × 109/L vs 0.97 ± 0.33 × 109/L, P < 0.05), elevated neutrophil to lymphocyte ratio (NLR; 14.67 ± 6.10 and 14.64 ± 10.36 vs 6.29 ± 3.72, P < 0.05) compared to COVID-19. Especially in influenza A patients, NLR was significant different between the patients with or without death. Compared with the H7N9 group, ground glass opacity (GGO) on chest CT was more common in the COVID-19 group (P = 0.028), while pleural effusion was relatively rare (P = 0.001).Conclusion Compared to COVID-19, patients with Influenza A (H7N9 and H1N1) had more underlying chronic diseases and higher mortality rates. The NLR can be used as a clinical parameter for the predication of risk stratification and outcome in COVID-19 and Influenza A pneumonia. Manifestations of pleural effusion or GGO in chest CT may be helpful for the identification of different viral pneumonia.