Higher mortality of hospitalized haematologic patients with COVID-19 compared to non-haematologic is driven by thrombotic complications and development of ARDS: An age-matched cohorts study.

BACKGROUND AND OBJECTIVES: The characteristics of COVID-19 in haematologic patients compared to non-haematologic patients have seldom been analyzed. Our aim was to analyze whether there are differences in clinical characteristics and outcome of haematologic patients with COVID-19 as compared to non-haematologic. PATIENTS AND METHODS: Retrospective cohort study in 2 University hospitals of patients admitted with laboratory-confirmed COVID-19 included in the SEMICOVID19 database. The cohort with underlying haematologic disease was compared to a cohort of age and date-of-COVID-19-matched controls without haematologic disease (1:2). RESULTS: 71 cases and 142 controls were included from March-May 2020.Twenty (28.1%) had received recent chemotherapy. Twelve (16.9%) were stem cell transplant recipients (SCT). Eleven (15.5%) were neutropenic concurrently with COVID-19 diagnosis.Haematologic patients presented ARDS (58.5 vs 20.7%, p = 0.0001), thrombotic complications (15.7 vs 2.1%, p = 0.002), DIC (5.7 vs 0.0%, p = 0.011), heart failure (14.3 vs 4.9%, p = 0.029) and required ICU admission (15.5 vs 2.8%, p = 0.001), MV (14.1% vs 2.1%, p 0.001), steroid (64.8 vs 33.1%, p = 0.0001), tocilizumab (33.8 vs 8.5%, p = 0.0001) or anakinra treatment (9.9% vs 0%, p = 0.0001) more often. In-hospital mortality was significantly higher (38.0% vs 18.3%, p = 0.002). CONCLUSIONS: Our results suggest COVID-19 has worse outcomes in haematologic patients than in non-haematologic, independently of age, and that the development of ARDS and thrombotic complications drive the higher in-hospital mortality.

SARS-COV-2 infection in the perioperative of pulmonary lobectomy. About a case.

OBJECTIVE: To describe the form of severe clinical presentation of SARS-COV-2 infection in the early phase, also the timely treatment of COVID-19 pneumonia in postoperative pulmonary lobectomy. METHOD: Case report where the data were extracted from the clinical history and is in accordance with the SCARE 2018 criteria. DESCRIPTION OF THE CASE: A 36-year-old man, with no significant history, who presented fever and mucopurulent expectoration of 1 month of evolution, received antibiotics for 4 weeks without response to treatment. Chest tomography shows cystic image with heterogeneous content in the left lower lobe. We decided to opt for surgery, previously 1 PCR in RT and 7 serological tests for COVID-19 were performed, the result of which was non-reactive. In the postoperative period, the patient developed fever and dyspnea on mild exertion, so a new serological test for COVID-19 was performed: IgM/IgG reactive, in addition chest tomography showed both lungs with "cracy paving" pattern. DISCUSSION: The serological tests did not contribute to a timely diagnosis of COVID-19 and generated confusion. We used oxygen therapy, broad spectrum antibiotics since the diagnosis of COVID-19. Likewise, respiratory physiotherapy was intensified even after discharge. CONCLUSION: The early diagnosis and use of antibiotics at doses of sepsis, associated with corticosteroid pulses and respiratory physiotherapy improve COVID-19 pneumonia in postoperative lung surgery.