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Br J Haematol ; 201(4): 640-644, 2023 05.
Article in English | MEDLINE | ID: covidwho-2286731


Haematology patients contracting SARS-CoV-2 were identified at the start of the pandemic to be at higher risk of death or of persistent symptoms (post-COVID-19 syndrome). As variants with altered pathogenicity have emerged, uncertainty remains around how that risk has changed. We prospectively set up a dedicated post-COVID-19 clinic to monitor haematology patients infected with COVID-19 from the start of the pandemic. In total, 128 patients were identified and telephone interviews were conducted with 94 of 95 survivors. Ninety-day mortality attributed to COVID-19 has fallen sequentially from 42% for the Original and Alpha strains to 9% and to 2% for the Delta and Omicron variants respectively. Furthermore, the risk of post-COVID-19 syndrome in survivors has fallen from 46% for the Original or Alpha strains to 35% for Delta and 14% for the Omicron strain. Since vaccine uptake has been nearly universal in haematology patients, it is not possible to determine whether improved outcomes reflect the reduced pathogenicity of the virus, or widespread vaccine deployment. Whilst mortality and morbidity remain higher in haematology patients than in the general population, our data suggest that the absolute risks are now significantly lower. Given this trend, we believe clinicians should initiate conversations about risk with their patients on whether to maintain any self-imposed social isolation.

COVID-19 , Hematology , Humans , SARS-CoV-2 , Post-Acute COVID-19 Syndrome
Br J Psychiatry ; 217(2): 408-409, 2020 08.
Article in English | MEDLINE | ID: covidwho-698109


The coronavirus disease 2019 pandemic has led to unprecedented disruption to the normal way of life for people around the globe. Social distancing, self-isolation or shielding have been strongly advised or mandated in most countries. We suggest evidence-based ways that people can maintain or even strengthen their mental health during this crisis.

Betacoronavirus , Coronavirus Infections/psychology , Mental Health , Pneumonia, Viral/psychology , Quarantine/psychology , Social Isolation/psychology , COVID-19 , Humans , Pandemics , SARS-CoV-2
Eur J Haematol ; 105(4): 476-483, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-599960


OBJECTIVES: We sought to characterise the outcomes of patients with haematological malignancy and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in hospital in our regional network of 7 hospitals. METHODS: Consecutive hospitalised patients with haematological malignancy and SARS-CoV-2 infection were identified from 01/03/2020 to 06/05/2020. Outcomes were categorised as death, resolved or ongoing. The primary outcome was preliminary case fatality rate (pCFR), defined as the number of cases resulting in death as a proportion of all diagnosed cases. Analysis was primarily descriptive. RESULTS: 66 Patients were included, overall pCFR was 51.5%. Patients ≥ 70 years accounted for the majority of hospitalised cases (42, 63%) and fatalities (25, 74%). Mortality was similar between females (52%) and males (51%). Immunosuppressive or cytotoxic treatment within 3 months of the diagnosis of SARS-CoV-2 infection was associated with a significantly higher pCFR of 70%, compared with 28% in those not on active treatment (P = .0013, 2 proportions z test). CONCLUSIONS: Mortality rates in patients with haematological malignancy and SARS-CoV-2 infection in hospital are high supporting measures to minimise the risk of infection in this population.

COVID-19/complications , Hematologic Neoplasms/complications , Aged , Aged, 80 and over , Antineoplastic Agents/adverse effects , COVID-19/mortality , COVID-19/prevention & control , Cytotoxins/adverse effects , Female , Hematologic Neoplasms/therapy , Hospitalization , Humans , Immunosuppression Therapy/adverse effects , Male , Middle Aged , Pandemics , Prospective Studies , SARS-CoV-2 , United Kingdom/epidemiology