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Secondary infections worsen the outcome of COVID-19 in patients with hematological malignancies: A report from the ITA-HEMA-COV.
Zappasodi, Patrizia; Cattaneo, Chiara; Valeria Ferretti, Virginia; Mina, Roberto; José María Ferreri, Andrés; Merli, Francesco; Oberti, Margherita; Krampera, Mauro; Romano, Alessandra; Zerbi, Caterina; Ferrari, Jacqueline; Cavo, Michele; Salvini, Marco; Bertù, Lorenza; Stefano Fracchiolla, Nicola; Marchesi, Francesco; Massaia, Massimo; Marasco, Vincenzo; Cairoli, Roberto; Maria Scattolin, Anna; Maria Vannucchi, Alessandro; Gambacorti-Passerini, Carlo; Musto, Pellegrino; Gherlinzoni, Filippo; Cuneo, Antonio; Pinto, Antonello; Trentin, Livio; Bocchia, Monica; Galimberti, Sara; Coviello, Elisa; Chiara Tisi, Maria; Morotti, Alessandro; Falini, Brunangelo; Turrini, Mauro; Tafuri, Agostino; Billio, Atto; Gentile, Massimo; Massimo Lemoli, Roberto; Venditti, Adriano; Giovanni Della Porta, Matteo; Lanza, Francesco; Rigacci, Luigi; Tosi, Patrizia; Mohamed, Sara; Corso, Alessandro; Luppi, Mario; Giuliani, Nicola; Busca, Alessandro; Pagano, Livio; Bruno, Raffaele.
  • Zappasodi P; Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  • Cattaneo C; Division of Hematology, Azienda Socio-Sanitaria Territoriale-Spedali Civili, Brescia, Italy.
  • Valeria Ferretti V; Clinical Epidemiology and Biostatistic Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  • Mina R; SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy.
  • José María Ferreri A; Division of Hematology, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Scientific Institute, Milan, Italy.
  • Merli F; Division of Hematology, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy.
  • Oberti M; Division of Hematology and Transplant Unit, ASST Spedali Civili, Brescia, Italy.
  • Krampera M; Division of Hematology, Azienda Ospedaliera Integrata di Verona, Verona, Italy.
  • Romano A; Division of Hematology and Bone Marrow Transplantation, Azienda Ospedaliera Universitaria Policlinico "G. Rodolico-San Marco", Catania, Italy.
  • Zerbi C; Department of Molecular Medicine, University of Pavia, Pavia, Italy.
  • Ferrari J; Department of Molecular Medicine, University of Pavia, Pavia, Italy.
  • Cavo M; Division of Hematology, Azienda Ospedaliero-Universitaria Policlinico S. Orsola-Malpighi, Bologna, Italy.
  • Salvini M; UOC Ematologia, Azienda Socio-Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy.
  • Bertù L; Department of Medicine and Surgery, University of Insubria, Varese, Italy.
  • Stefano Fracchiolla N; UOC Ematologia, Azienda Socio-Sanitaria Territoriale Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy.
  • Marchesi F; Department of Medicine and Surgery, University of Insubria, Varese, Italy.
  • Massaia M; Hematology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
  • Marasco V; IRCCS Regina Elena National Cancer Institute, Rome, Italy.
  • Cairoli R; Division of Hematology, Santa Croce Hospital, Cuneo, Italy.
  • Maria Scattolin A; Division of Hematology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, University of Milan, Milan, Italy.
  • Maria Vannucchi A; Hematology, Azienda Socio-Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Gambacorti-Passerini C; Division of Hematology, Azienda Unità Locale Socio-Sanitaria 3 Serenissima, Ospedale dell'Angelo, Venezia-Mestre, Venice, Italy.
  • Musto P; Division of Hematology, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy.
  • Gherlinzoni F; Division of Hematology, Ospedale S. Gerardo di Monza, Monza, Italy.
  • Cuneo A; Department of Emergency and Organ Transplantation, "Aldo Moro" University School of Medicine and Unit of Hematology and Stem Cell Transplantation, AOUC Policlinico, Bari, Italy.
  • Pinto A; Division of Hematology, Ospedale Ca' Foncello, Treviso, Italy.
  • Trentin L; Division of Hematology, Azienda Ospedaliero Universitaria Arcispedale S. Anna, Ferrara, Italy.
  • Bocchia M; Hematology, Istituto Nazionale Tumori Istituto di Ricovero e Cura a Carattere Scientifico "Fondazione G Pascale," Naples, Naples, Italy.
  • Galimberti S; Division of Hematology, Azienda Ospedaliera di Padova, Padova, Italy.
  • Coviello E; Division of Hematology, Policlinico Santa Maria alle Scotte, Siena, Italy.
  • Chiara Tisi M; Division of Hematology, Azienda Ospedaliera Universitaria Pisana- Santa Chiara, Pisa, Italy.
  • Morotti A; Ematologia e terapie cellulari. IRCCS Ospedale Policlinico San Martino, Genova, Italy.
  • Falini B; Division of Hematology, Ospedale San Bortolo, Vicenza, Italy.
  • Turrini M; Department of Clinical and Biological Sciences, University of Torino, Orbassano, Italy.
  • Tafuri A; Division of Hematology and Transplant Unit, Azienda Ospedaliera di Perugia, Perugia, Italy.
  • Billio A; Division of Hematology, Ospedale Valduce, Como, Italy.
  • Gentile M; Division of Hematology, University Hospital Sant'Andrea, Sapienza, Rome, Italy.
  • Massimo Lemoli R; Division of Hematology and Transplant Unit, Ospedale di Bolzano, Bolzano, Italy.
  • Venditti A; Division of Hematology, Azienda Ospedaliera di Cosenza, Cosenza, Italy.
  • Giovanni Della Porta M; Department of Internal Medicine (DiMI), Clinic of Hematology, University of Genoa, Genoa, Italy.
  • Lanza F; IRCCS- San Martino Hospital, Genoa, Italy.
  • Rigacci L; Department of Biomedicine and Prevention, University Tor Vergata Rome, Rome, Italy.
  • Tosi P; Division of Hematology, Humanitas Clinical and Research Hospital Istituto di Ricovero e Cura a Carattere Scientifico and Department of Biomedical Sciences, Humanitas University, Milan, Italy.
  • Mohamed S; Division of Hematology, Ospedale Santa Maria delle Croci, Ravenna, Italy.
  • Corso A; Division of Hematology and Transplant Unit, Azienda Ospedaliera S. Camillo-Forlanini, Rome, Italy.
  • Luppi M; Division of Hematology, Ospedale degli Infermi, Rimini, Italy.
  • Giuliani N; SC Ematologia, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy.
  • Busca A; Division of Hematology, Ospedale di Legnano, Legnano, Italy.
  • Pagano L; Department of Medical and Surgical Sciences, UNIMORE. Division of Hematology Azienda Ospedaliero Universitaria Modena, Modena, Italy.
  • Bruno R; Division of Hematology and Transplant Unit, Azienda Ospedaliero-Universitaria di Parma, S, Italy.
Hematol Oncol ; 2022 Jul 19.
Article in English | MEDLINE | ID: covidwho-1935680
ABSTRACT
The impact of secondary infections (SI) on COVID-19 outcome in patients with hematological malignancies (HM) is scarcely documented. To evaluate incidence, clinical characteristics, and outcome of SI, we analyzed the microbiologically documented SI in a large multicenter cohort of adult HM patients with COVID-19. Among 1741 HM patients with COVID-19, 134 (7.7%) had 185 SI, with a 1-month cumulative incidence of 5%. Median time between COVID-19 diagnosis and SI was 16 days (IQR 5-36). Acute myeloid leukemia (AML) and lymphoma/plasma cell neoplasms (PCN) were more frequent diagnoses in SI patients compared to patients without SI (AML 14.9% vs. 7.1%; lymphoma/PCN 71.7% vs. 65.3%). Patients with SI were older (median age 70 vs. 66 years, p = 0.002), with more comorbidities (median Charlson Comorbidity Index 5 vs. 4, p < 0.001), higher frequency of critical COVID-19 (19.5% vs. 11.5%, p = 0.046), and more frequently not in complete remission (75% vs. 64.7% p = 0.024). Blood and bronchoalveolar lavage were the main sites of isolation for SI. Etiology of infections was bacterial in 80% (n = 148) of cases, mycotic in 9.7% (n = 18) and viral in 10.3% (n = 19); polymicrobial infections were observed in 24 patients (18%). Escherichia coli represented most of Gram-negative isolates (18.9%), while coagulase-negative Staphylococci were the most frequent among Gram-positive (14.2%). The 30-day mortality of patients with SI was higher when compared to patients without SI (69% vs. 15%, p < 0.001). The occurrence of SI worsened COVID-19 outcome in HM patients. Timely diagnosis and adequate management should be considered to improve their prognosis.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Year: 2022 Document Type: Article Affiliation country: Hon.3048

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Year: 2022 Document Type: Article Affiliation country: Hon.3048