Your browser doesn't support javascript.
Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study.
Passamonti, Francesco; Cattaneo, Chiara; Arcaini, Luca; Bruna, Riccardo; Cavo, Michele; Merli, Francesco; Angelucci, Emanuele; Krampera, Mauro; Cairoli, Roberto; Della Porta, Matteo Giovanni; Fracchiolla, Nicola; Ladetto, Marco; Gambacorti Passerini, Carlo; Salvini, Marco; Marchetti, Monia; Lemoli, Roberto; Molteni, Alfredo; Busca, Alessandro; Cuneo, Antonio; Romano, Alessandra; Giuliani, Nicola; Galimberti, Sara; Corso, Alessandro; Morotti, Alessandro; Falini, Brunangelo; Billio, Atto; Gherlinzoni, Filippo; Visani, Giuseppe; Tisi, Maria Chiara; Tafuri, Agostino; Tosi, Patrizia; Lanza, Francesco; Massaia, Massimo; Turrini, Mauro; Ferrara, Felicetto; Gurrieri, Carmela; Vallisa, Daniele; Martelli, Maurizio; Derenzini, Enrico; Guarini, Attilio; Conconi, Annarita; Cuccaro, Annarosa; Cudillo, Laura; Russo, Domenico; Ciambelli, Fabrizio; Scattolin, Anna Maria; Luppi, Mario; Selleri, Carmine; Ortu La Barbera, Elettra; Ferrandina, Celestino.
  • Passamonti F; Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy. Electronic address: francesco.passamonti@uninsubria.it.
  • Cattaneo C; Haematology, ASST-Spedali Civili, Brescia, Italy.
  • Arcaini L; Department of Molecular Medicine, University of Pavia, Pavia, Italy; Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  • Bruna R; Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont and Ospedale Maggiore della Carità, Novara, Italy.
  • Cavo M; Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, Bologna, Italy.
  • Merli F; Hematology, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy.
  • Angelucci E; Hematology, Ospedale Policlinico San Martino, Genoa, Italy.
  • Krampera M; Department of Medicine, Section of Hematology, University of Verona, Verona, Italy.
  • Cairoli R; Hematology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  • Della Porta MG; Humanitas Clinical and Research Hospital-IRCCS and Department of Biomedical Sciences, Humanitas University, Milan, Italy.
  • Fracchiolla N; Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy.
  • Ladetto M; Hematology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
  • Gambacorti Passerini C; Department of Hematology, Università degli Studi di Milano-Bicocca, Milan, Italy.
  • Salvini M; Department of Medicine and Surgery, University of Insubria and ASST Sette Laghi, Ospedale di Circolo of Varese, Varese, Italy.
  • Marchetti M; Hematology, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
  • Lemoli R; Dipartimento di Medicina interna e Specialità mediche, University of Genoa, Genoa, Italy.
  • Molteni A; Hematology, ASST Cremona, Cremona, Italy.
  • Busca A; Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy.
  • Cuneo A; Hematology, Azienda Ospedaliero Universitaria Sant'Anna, Ferrara, Italy.
  • Romano A; Hematology, Dipartimento di Chirurgia e Specialità Medico Chirurgiche, Università degli Studi di Catania, Catania, Italy.
  • Giuliani N; Dipartimento di Medicina e Chirurgia, University of Parma, Parma, Italy.
  • Galimberti S; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
  • Corso A; Hematology, ASST Ovest Milanese, Milan, Italy.
  • Morotti A; Department of Clinical and Biological Sciences, Università di Torino, Turin, Italy.
  • Falini B; Department of Medicine, University of Perugia, Perugia, Italy.
  • Billio A; Ospedale di Bolzano, Bolzano, Italy.
  • Gherlinzoni F; Hematology, Ospedale Ca' Foncello, Treviso, Italy.
  • Visani G; Dipartimento di Onco- Ematologia, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy.
  • Tisi MC; Hematology, Ospedale San Bortolo, Vicenza, Italy.
  • Tafuri A; Hematology, University Hospital Sant'Andrea, Sapienza, Rome, Italy; Department of Clinical and Molecular Medicine, Sapienza, University of Rome, Rome, Italy.
  • Tosi P; Hematology, Ospedale degli Infermi di Rimini, Rimini, Italy.
  • Lanza F; Hematology, Santa Maria delle Croci, Ravenna, Italy.
  • Massaia M; Hematology, Santa Croce Hospital, Cuneo, Italy.
  • Turrini M; Hematology, Ospedale Valduce, Como, Italy.
  • Ferrara F; Hematology, Ospedale Antonio Cardarelli, Naples, Italy.
  • Gurrieri C; Dipartimento Strutturale Aziendale Medicina, University of Padova, Padova, Italy.
  • Vallisa D; Hematology, Ospedale di Piacenza, Piacenza, Italy.
  • Martelli M; Hematology, Department of Translational and Precision Medicine, Sapienza, University of Rome, Rome, Italy.
  • Derenzini E; Hematology, Istituto Europeo di Oncologia, Milan, Italy.
  • Guarini A; Hematology, Istituto Tumori Giovanni Paolo II, Bari, Italy.
  • Conconi A; Hematology, Ospedale degli Infermi, Biella, Italy.
  • Cuccaro A; Ematologia, USL 6 Livorno, Livorno, Italy.
  • Cudillo L; Hematology, San Giovanni Addolorata Hospital, Rome, Italy.
  • Russo D; Dipartimento di Scienze Cliniche e Sperimentali, University of Brescia, Brescia, Italy.
  • Ciambelli F; Dipartimento Oncologico, ASST Valle Olona, Busto Arsizio, Italy.
  • Scattolin AM; Hematology, Ospedale dell'Angelo di Mestre, Venice, Italy.
  • Luppi M; Dipartimento di Scienze Mediche e Chirurgiche Materno-Infantili e dell'Adulto, University of Modena and Reggio Emilia, Azienda Ospedaliera Universitaria, Modena, Italy.
  • Selleri C; Hematology, Ospedale San Giovanni di Dio e Ruggi D'Aragona, Salerno, Italy.
  • Ortu La Barbera E; UOC Ematologia con Trapianto, Ospedale Santa Maria Goretti, Latina, Italy; Hematology, Ospedale Santa Maria Goretti, Latina, Italy.
  • Ferrandina C; Hematology, Ospedali Riuniti Azienda Ospedaliera Universitaria di Foggia, Foggia, Italy.
Lancet Haematol ; 7(10): e737-e745, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-712017
Semantic information from SemMedBD (by NLM)
1. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
2. Hematologic Neoplasms PROCESS_OF Patients
Subject
Hematologic Neoplasms
Predicate
PROCESS_OF
Object
Patients
3. COVID-19 COEXISTS_WITH risk factors
Subject
COVID-19
Predicate
COEXISTS_WITH
Object
risk factors
4. Hospitalization TREATS COVID-19
Subject
Hospitalization
Predicate
TREATS
Object
COVID-19
5. Cessation of life PROCESS_OF Cohort
Subject
Cessation of life
Predicate
PROCESS_OF
Object
Cohort
6. follow-up TREATS Outpatients
Subject
follow-up
Predicate
TREATS
Object
Outpatients
7. COVID-19 PROCESS_OF General Population
Subject
COVID-19
Predicate
PROCESS_OF
Object
General Population
8. Hematologic Neoplasms PROCESS_OF Cohort
Subject
Hematologic Neoplasms
Predicate
PROCESS_OF
Object
Cohort
9. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
10. Hematologic Neoplasms PROCESS_OF Patients
Subject
Hematologic Neoplasms
Predicate
PROCESS_OF
Object
Patients
11. COVID-19 COEXISTS_WITH risk factors
Subject
COVID-19
Predicate
COEXISTS_WITH
Object
risk factors
12. Hospitalization TREATS COVID-19
Subject
Hospitalization
Predicate
TREATS
Object
COVID-19
13. Cessation of life PROCESS_OF Cohort
Subject
Cessation of life
Predicate
PROCESS_OF
Object
Cohort
14. follow-up TREATS Outpatients
Subject
follow-up
Predicate
TREATS
Object
Outpatients
15. COVID-19 PROCESS_OF General Population
Subject
COVID-19
Predicate
PROCESS_OF
Object
General Population
16. Hematologic Neoplasms PROCESS_OF Cohort
Subject
Hematologic Neoplasms
Predicate
PROCESS_OF
Object
Cohort
ABSTRACT

BACKGROUND:

Several small studies on patients with COVID-19 and haematological malignancies are available showing a high mortality in this population. The Italian Hematology Alliance on COVID-19 aimed to collect data from adult patients with haematological malignancies who required hospitalisation for COVID-19.

METHODS:

This multicentre, retrospective, cohort study included adult patients (aged ≥18 years) with diagnosis of a WHO-defined haematological malignancy admitted to 66 Italian hospitals between Feb 25 and May 18, 2020, with laboratory-confirmed and symptomatic COVID-19. Data cutoff for this analysis was June 22, 2020. The primary outcome was mortality and evaluation of potential predictive parameters of mortality. We calculated standardised mortality ratios between observed death in the study cohort and expected death by applying stratum-specific mortality rates of the Italian population with COVID-19 and an Italian cohort of 31 993 patients with haematological malignancies without COVID-19 (data up to March 1, 2019). Multivariable Cox proportional hazards model was used to identify factors associated with overall survival. This study is registered with ClinicalTrials.gov, NCT04352556, and the prospective part of the study is ongoing.

FINDINGS:

We enrolled 536 patients with a median follow-up of 20 days (IQR 10-34) at data cutoff, 85 (16%) of whom were managed as outpatients. 440 (98%) of 451 hospitalised patients completed their hospital course (were either discharged alive or died). 198 (37%) of 536 patients died. When compared with the general Italian population with COVID-19, the standardised mortality ratio was 2·04 (95% CI 1·77-2·34) in our whole study cohort and 3·72 (2·86-4·64) in individuals younger than 70 years. When compared with the non-COVID-19 cohort with haematological malignancies, the standardised mortality ratio was 41·3 (38·1-44·9). Older age (hazard ratio 1·03, 95% CI 1·01-1·05); progressive disease status (2·10, 1·41-3·12); diagnosis of acute myeloid leukaemia (3·49, 1·56-7·81), indolent non-Hodgin lymphoma (2·19, 1·07-4·48), aggressive non-Hodgkin lymphoma (2·56, 1·34-4·89), or plasma cell neoplasms (2·48, 1·31-4·69), and severe or critical COVID-19 (4·08, 2·73-6·09) were associated with worse overall survival.

INTERPRETATION:

This study adds to the evidence that patients with haematological malignancies have worse outcomes than both the general population with COVID-19 and patients with haematological malignancies without COVID-19. The high mortality among patients with haematological malignancies hospitalised with COVID-19 highlights the need for aggressive infection prevention strategies, at least until effective vaccination or treatment strategies are available.

FUNDING:

Associazione italiana contro le leucemie, linfomi e mieloma-Varese Onlus.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Hematologic Neoplasms / Pandemics / Betacoronavirus Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Risk factors Topics: Vaccines Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: Lancet Haematol Year: 2020 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Hematologic Neoplasms / Pandemics / Betacoronavirus Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Risk factors Topics: Vaccines Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Country/Region as subject: Europa Language: English Journal: Lancet Haematol Year: 2020 Document Type: Article