The assessment of impact of covid-19 in patients with acute leukemia

ABSTRACT

Background: The severe acute respiratory syndrome coronavirus-2 (SARSCoV-2) was first reported in Wuhan, China in December2019 and represented the pathogen agent that induced COVID-19. The onset and evolution of COVID -19 is severe when is associated with another comorbidities. Patients with acute leukemia present high risk for severe form of COVID-19 Aims: The main objective was to evaluate the particularities of COVID-19 in patients with acute leukemia. Methods: Our study was prospective and included 49 patients with acute leukemia (27 male median age 64 and22 female median age 54,5) who also were SARS CoV2 positive between April2020- February2021 admitted in Hematology and Intensive Care Unit Departments of Colentina Clinical Hospital Bucharest. The diagnosis was established using molecular test for SARS-Cov2 Results: In the group was included 32 patients diagnosed with acute myeloid leukemia (AML), 9 patients with acute lymphoid leukemia (ALL), 6 patients with acut promyelocytic leukemia and2 patients with acute bifenotypic leukemia. Severe form of COVID-19 with ICU addmission was diagnosed in16 patients (32,17%), almost all of them (15 patients) had unfavourable evolution compared with non-ICU patients group with only1 deceased patient, p<0.0001. The recent chemotherapy followed by severe aplasia was the main negative factor that impacted patient evolution (rho=0.508, p=0.0002),13 patients admitted in ICU Department and12 patients in non-ICU. Severe pneumonia (more than 30% lung field) was diagnosed in17 patients with recent chemotherapy and 4 untreated patients. The type of leukemia or refractory status have not any impact of patient evolution. Antiviral therapy - Remdesivir rapidly introduced in patient's therapy was followed by favourable evolution. Summary/Conclusion: Patients with acute leukemia are negatively impacted by intensive chemotherapy during COVID-19 evolution. The key for good prognosis of these patients during COVID-19 are rapid diagnosis and antiviral therapy at the onset of the disease.