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1.
Blood ; 138:2520, 2021.
Article in English | EMBASE | ID: covidwho-1582169

ABSTRACT

Updated analysis confirms sustained poor prognosis of COVID-19 in patients with lymphoma in Latin America: A cohort of 160 patients from GELL. Introduction: Ongoing SARS-COV-2 pandemic has impacted the management of cancer patients worldwide. Several reports have demonstrated inferior outcomes of patients with hematological malignancies, including higher rates of intensive care unit admission, need for mechanical ventilation and death. The impact of COVID-19 is profound in resource-restricted countries, including Latin America. Most cohorts reported have not included patients from Latin America, and there is paucity of data of the outcome of cancer patients with COVID-19 in low- and middle-income countries. Grupo de Estudio De Linfoproliferativos En Latino-America (GELL )is a collaborative network of hematological centers in 13 countries in Latin America. We report updated outcomes of lymphoma patients diagnosed with COVID-19 in Latin America. Methods: We conducted a retrospective study including patients with a diagnosis of lymphoma and COVID-19 infection. Patients with chronic lymphocytic leukemia/small lymphocytic lymphoma were excluded from the analysis We defined active disease as follow: (1) patients with detectable disease either prior to initiating therapy or upon relapse, and/or (2) patients undergoing active cancer treatment. The primary outcome was overall survival at 100 days. Survival curves were estimated using the Kaplan Meier method. Uni and multivariable analysis were carried out with Cox model. Results: A total of 160 patients were available for analysis. Median age was 60 years old. Hypertension was the most common comorbidity (33%). Most patients had aggressive lymphomas (62%), including 43% of patients with diffuse large B-Cell lymphoma (DLBCL). Follicular lymphomas were observed in 13% of patients and Hodgkin lymphoma in 12.5% of patients. With a median follow-up of 37 days, the 100-day OS was 64% (95CI 56-74%, fig. 1). In univariate analysis, age (HR 1.03, p=0.0025), hypertension (HR 2.01, p=0.017), >1 number of prior lines (HR 2.78, p=0.011), patients currently on treatment (HR 1.83, p=0.043), ferritin >2000 ng/mL (HR 4.74 p=0.00047) were associated with inferior OS. In multivariate analysis, age (HR 1.03, p=0.0026) and patients currently on treatment (HR 1.82, p=0.04) had inferior OS. There was a trend towards inferior outcomes in patients receiving monoclonal antibodies in univariate analysis (HR 1.82, p=0.081) but not in multivariable analysis (HR=1.29, p=0.48). Use of steroids was not statistically related to mortality (HR 1.79, p=0.074). Finally, contrary to other cohorts, no improvement in OS was observed in patients diagnosed later on the pandemic (fig. 2). Conclusion: In this large cohort of Latin American patients with lymphoma malignancies, our updated analysis showed a maintained dismal prognosis with COVID-19 infection. With a median follow up of 37 days, the 100-day OS was 64%. Older age and ongoing active cancer treatment were significantly associated with mortality. The use of monoclonal antibodies and systemic corticosteroids were not statistically associated to poor survival. Current efforts are focused on improving immunization in the Latin American population. There is an unmet need for improving survival in patients with hematologic malignancies and COVID-19 infection. [Formula presented] Disclosures: Perini: Janssen: Honoraria, Speakers Bureau;Takeda: Honoraria, Speakers Bureau;Astra Zeneca: Honoraria, Speakers Bureau;MSD: Honoraria, Speakers Bureau. Otero: ASTRA ZENECA: Current Employment. Abello: Dr Reddy's: Research Funding;Amgen: Honoraria;Janssen: Honoraria. Castillo: Abbvie: Consultancy, Research Funding;BeiGene: Consultancy, Research Funding;Pharmacyclics: Consultancy, Research Funding;Janssen: Consultancy;Roche: Consultancy;TG Therapeutics: Research Funding.

2.
Revista Ecuatoriana de Neurologia ; 29(1):115-124, 2020.
Article in Spanish | EMBASE | ID: covidwho-1257668

ABSTRACT

Background. In December 2019, multiple cases of pneumonia of unknown etiology surged in China. In January 2020, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was the identified cause. The World Health Organization (WHO) defined the condition as "Coronavirus 2019 Disease" (COVID-19). In February, its presence was confirmed in South America and Ecuador. On March 11th, the WHO declared COVID-19 as a pandemic. This condition mainly afflicts the respiratory system. However, reports of neurological manifestations in confirmed COVID-19 p atients have recently emerged. Methods. Multiple databases were reviewed, the information was extracte d and analyzed independently by 3 authors. Results. Neurological manifestations associated with COVID-19 were identified. Including: myalgia, headache, altered mental status, cerebrovascular events, dizziness, hypogeusia, hyposmia, neuropathic pain, visual impairment, ataxia, seizures, Central Hypoventilation Syndrome, encephalopathy, rhabdomyolysis, Acute Hemorrhagic Necrotizing Encephalopathy, Guillain Barre Syndrome (GBS), meningitis and encephalitis.Conclusion. COVID-19 is associated with neurological involvement. It is most frequently observed in cases that are severe, atypical, and with comorbidities. Health care providers and neurologists alike, must remain alert and keep high suspicion of severity when these manifestations are present. Timely recognition might help initiate early treatment and isolation, preventing clinical decline and viral spread.

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