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Predictors of clinical evolution of SARS-CoV-2 infection in hematological patients: A systematic review and meta-analysis.
Carrara, Elena; Razzaboni, Elisa; Azzini, Anna Maria; De Rui, Maria Elena; Pinho Guedes, Mariana Nunes; Gorska, Anna; Giannella, Maddalena; Bussini, Linda; Bartoletti, Michele; Arbizzani, Federica; Palacios-Baena, Zaira R; Caponcello, Giulia; Maldonado, Natalia; Rodríguez-Baño, Jesús; Visco, Carlo; Krampera, Mauro; Tacconelli, Evelina.
  • Carrara E; Department of Diagnostics and Public Health, Division of Infectious Diseases, University of Verona, Verona, Italy.
  • Razzaboni E; Department of Diagnostics and Public Health, Division of Infectious Diseases, University of Verona, Verona, Italy.
  • Azzini AM; Department of Diagnostics and Public Health, Division of Infectious Diseases, University of Verona, Verona, Italy.
  • De Rui ME; Department of Diagnostics and Public Health, Division of Infectious Diseases, University of Verona, Verona, Italy.
  • Pinho Guedes MN; Department of Diagnostics and Public Health, Division of Infectious Diseases, University of Verona, Verona, Italy.
  • Gorska A; Department of Diagnostics and Public Health, Division of Infectious Diseases, University of Verona, Verona, Italy.
  • Giannella M; Department of Medical and Surgical Sciences, Infectious Diseases Unit, IRCCS Policlinico Sant'Orsola, University of Bologna, Bologna, Italy.
  • Bussini L; Department of Medical and Surgical Sciences, Infectious Diseases Unit, IRCCS Policlinico Sant'Orsola, University of Bologna, Bologna, Italy.
  • Bartoletti M; Department of Medical and Surgical Sciences, Infectious Diseases Unit, IRCCS Policlinico Sant'Orsola, University of Bologna, Bologna, Italy.
  • Arbizzani F; Department of Medical and Surgical Sciences, Infectious Diseases Unit, IRCCS Policlinico Sant'Orsola, University of Bologna, Bologna, Italy.
  • Palacios-Baena ZR; Department of Medicine, Infectious Diseases and Microbiology Unit, Hospital Universitario Virgen Macarena, University of Seville, Biomedicine Institute of Seville (IBiS) / CSIC; and Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Seville, Spain.
  • Caponcello G; Department of Medicine, Infectious Diseases and Microbiology Unit, Hospital Universitario Virgen Macarena, University of Seville, Biomedicine Institute of Seville (IBiS) / CSIC; and Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Seville, Spain.
  • Maldonado N; Department of Medicine, Infectious Diseases and Microbiology Unit, Hospital Universitario Virgen Macarena, University of Seville, Biomedicine Institute of Seville (IBiS) / CSIC; and Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Seville, Spain.
  • Rodríguez-Baño J; Department of Medicine, Infectious Diseases and Microbiology Unit, Hospital Universitario Virgen Macarena, University of Seville, Biomedicine Institute of Seville (IBiS) / CSIC; and Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Seville, Spain.
  • Visco C; Department of Medicine, Section of Hematology, University of Verona, Verona, Italy.
  • Krampera M; Department of Medicine, Section of Hematology, University of Verona, Verona, Italy.
  • Tacconelli E; Department of Diagnostics and Public Health, Division of Infectious Diseases, University of Verona, Verona, Italy.
Hematol Oncol ; 2022 Oct 13.
Article in English | MEDLINE | ID: covidwho-2228595
ABSTRACT
Main aim of this systematic review is to quantify the risk and identify predictors of clinical evolution of SARS-CoV-2 in hematological patients compared to different control populations. Two independent reviewers screened the literature assessing clinical outcomes of SARS-CoV-2 infection in adult patients with active hematological malignancies published up to June 2021. Primary outcome was COVID-19 related mortality, secondary outcomes were hospital and intensive-care admission, mechanical ventilation (MV), and thromboembolic events. Variables related to study setting, baseline patients' demographic, comorbidities, underlying hematological disease, ongoing chemotherapy, COVID-19 presentation, and treatments were extracted. A total of 67 studies including 10,061 hematological patients and 111,143 controls were included. Most of the studies were retrospective cohorts (51 studies, 76%) and only 19 (13%) provided data for a control group. A significant increased risk of clinical progression in the hematological population compared to the controls was found in terms of COVID-19 related mortality (OR, 2.12; 95% CI, 1.77-2.54), hospitalization (OR, 1.98; 95% CI, 1.15-3.43), intensive-care admission (OR, 1.77; 95% CI, 1.38-2.26), and MV (OR, 2.17; 95% CI, 1.71-2.75). The risk remained significantly higher in the subgroup analysis comparing hematological patients versus solid cancer. Meta-regression analysis of uncontrolled studies showed that older age, male sex, and hypertension were significantly related to worse clinical outcomes of COVID-19 in hematological population. Older age and hypertension were found to be associated also to thromboembolic events. In conclusion, hematological patients have a higher risk of COVID-19 clinical progression compared to both the general population and to patients with solid cancer.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Language: English Year: 2022 Document Type: Article Affiliation country: Hon.3084

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Language: English Year: 2022 Document Type: Article Affiliation country: Hon.3084