Asunto(s)
Vacuna BNT162/administración & dosificación , COVID-19/inmunología , ChAdOx1 nCoV-19/administración & dosificación , Gammopatía Monoclonal de Relevancia Indeterminada/inmunología , SARS-CoV-2/inmunología , Mieloma Múltiple Quiescente/inmunología , Vacunación , Anciano , Anticuerpos Antivirales , Vacuna BNT162/inmunología , COVID-19/prevención & control , ChAdOx1 nCoV-19/inmunología , Femenino , Humanos , MasculinoAsunto(s)
COVID-19/complicaciones , Mieloma Múltiple/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Formación de Anticuerpos , COVID-19/diagnóstico , COVID-19/inmunología , COVID-19/terapia , Prueba de COVID-19 , Vacunas contra la COVID-19/uso terapéutico , Femenino , Humanos , Inmunomodulación , Masculino , Persona de Mediana Edad , Mieloma Múltiple/inmunología , Mieloma Múltiple/terapia , SARS-CoV-2/inmunología , SARS-CoV-2/aislamiento & purificaciónRESUMEN
Haematology patients receiving chemo- or immunotherapy are considered to be at greater risk of COVID-19-related morbidity and mortality. We aimed to identify risk factors for COVID-19 severity and assess outcomes in patients where COVID-19 complicated the treatment of their haematological disorder. A retrospective cohort study was conducted in 55 patients with haematological disorders and COVID-19, including 52 with malignancy, two with bone marrow failure and one immune-mediated thrombotic thrombocytopenic purpura (TTP). COVID-19 diagnosis coincided with a new diagnosis of a haematological malignancy in four patients. Among patients, 82% were on systemic anti-cancer therapy (SACT) at the time of COVID-19 diagnosis. Of hospitalised patients, 37% (19/51) died while all four outpatients recovered. Risk factors for severe disease or mortality were similar to those in other published cohorts. Raised C-reactive protein at diagnosis predicted an aggressive clinical course. The majority of patients recovered from COVID-19, despite receiving recent SACT. This suggests that SACT, where urgent, should be administered despite intercurrent COVID-19 infection, which should be managed according to standard pathways. Delay or modification of therapy should be considered on an individual basis. Long-term follow-up studies in larger patient cohorts are required to assess the efficacy of treatment strategies employed during the pandemic.