COVID-19 Severity and Survival over Time in Patients with Hematologic Malignancies: A Population-Based Registry Study

Author:

Martínez-López Joaquín1ORCID,De la Cruz Javier2,Gil-Manso Rodrigo1,Alegre Adrián3ORCID,Ortiz Javier3ORCID,Llamas Pilar4,Martínez Yolanda4ORCID,Hernández-Rivas José-Ángel5ORCID,González-Gascón Isabel5ORCID,Benavente Celina6,Estival Monteliu Pablo6,Jiménez-Yuste Víctor7ORCID,Canales Miguel8ORCID,Bastos Mariana910ORCID,Kwon Mi910ORCID,Valenciano Susana11,Callejas-Charavia Marta12,López-Jiménez Javier13ORCID,Herrera Pilar13ORCID,Duarte Rafael14,Núñez Martín-Buitrago Lucía14,Sanchez Godoy Pedro15,Jacome Yerovi Cristina15,Martínez-Barranco Pilar16,García Roa María16,Escolano Escobar Cristian17,Matilla Arturo18ORCID,Rosado Sierra Belén19,Aláez-Usón María Concepción20,Quiroz-Cervantes Keina21,Martínez-Chamorro Carmen22,Pérez-Oteyza Jaime11,Martos-Martinez Rafael23,Herráez Regina24,González-Santillana Clara25,Del Campo Juan Francisco26,Alonso Arancha27,de la Fuente Adolfo28,Pascual Adriana29,Bustelos-Rodriguez Rosalía30,Sebrango Ana31,Ruiz Elena32,Marcheco-Pupo Eriel Alexis33,Grande Carlos8,Cedillo Ángel34,Lumbreras Carlos35,Arroyo Barea Andrés1,Casas-Rojo José Manuel36ORCID,Calbacho Maria1,Diez-Martín José Luis910,García-Suárez Julio12

Affiliation:

1. Hematology Department, Hospital Universitario 12 de Octubre, imas12, Universidad Complutense, CNIO-ISCIII, CIBERONC, 28041 Madrid, Spain

2. Research Institute, Hospital Universitario 12 de Octubre, imas12, 28041 Madrid, Spain

3. Hematology Department, Hospital Universitario de La Princesa, IIS-HUP, 28006 Madrid, Spain

4. Hematology Department, Hospital Fundación Jiménez Díaz, Health Research Institute IIS-FJD, 28040 Madrid, Spain

5. Hematology Department, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain

6. Hematology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain

7. Hematology Department, Hospital Universitario La Paz, 28046 Madrid, Spain

8. Hematology Department, Clínica Universidad de Navarra, 28027 Madrid, Spain

9. Hematology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain

10. Department of Medicine, Universidad Complutense, 28223 Madrid, Spain

11. Hematology Department, Hospital Universitario HM Sanchinarro, 28050 Madrid, Spain

12. Hematology Department, Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, Alcalá de Henares, 28805 Madrid, Spain

13. Hematology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain

14. Hematology Department, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain

15. Hematology Department, Hospital Universitario Severo Ochoa, 28911 Madrid, Spain

16. Hematology Department, Hospital Universitario Fundación Alcorcón, 28922 Madrid, Spain

17. Hematology Department, Hospital Universitario de Getafe, 28905 Madrid, Spain

18. Hematology Department, Hospital Central de la Defensa Gómez Ulla, 28047 Madrid, Spain

19. Hematology Department, Hospital Universitario Rey Juan Carlos, Móstoles, 28933 Madrid, Spain

20. Hematology Department, Hospital HLA Universitario Moncloa, 28027 Madrid, Spain

21. Hematology Department, Hospital Universitario de Móstoles, 28935 Madrid, Spain

22. Hematology Department, Hospital Universitario Quirónsalud Madrid, Pozuelo de Alarcón, 28223 Madrid, Spain

23. Hematology Department, Hospital Universitario General de Villalba, Villalba, 28400 Madrid, Spain

24. Hematology Department, Hospital Universitario Infanta Sofía, San Sebastián de Los Reyes, 28702 Madrid, Spain

25. Hematology Department, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain

26. Hematology Department, Hospital Universitario del Henares, Coslada, 28822 Madrid, Spain

27. Hematology Department, Hospital Ruber, 28006 Madrid, Spain

28. Hematology Department, MD Anderson Cancer Center Madrid, 28033 Madrid, Spain

29. Hematology Department, Hospital Universitario Infanta Elena, Valdemoro, 28340 Madrid, Spain

30. Hematology Department, Hospital Universitario del Sureste, Arganda del Rey, 28500 Madrid, Spain

31. Hematology Department, Hospital Universitario de Torrejón, 28850 Madrid, Spain

32. Hematology Department, Hospital Universitario del Tajo, Aranjuez, 28300 Madrid, Spain

33. Hematology Department, Hospital Universitario Infanta Cristina, Parla, 28980 Madrid, Spain

34. Asociación Madrileña de Hematología y Hemoterapia (AMHH), 28040 Madrid, Spain

35. Internal Medicine Department, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain

36. Internal Medicine Department, Hospital Universitario Infanta Cristina, Parla, 28980 Madrid, Spain

Abstract

Mortality rates for COVID-19 have declined over time in the general population, but data in patients with hematologic malignancies are contradictory. We identified independent prognostic factors for COVID-19 severity and survival in unvaccinated patients with hematologic malignancies, compared mortality rates over time and versus non-cancer inpatients, and investigated post COVID-19 condition. Data were analyzed from 1166 consecutive, eligible patients with hematologic malignancies from the population-based HEMATO-MADRID registry, Spain, with COVID-19 prior to vaccination roll-out, stratified into early (February–June 2020; n = 769 (66%)) and later (July 2020–February 2021; n = 397 (34%)) cohorts. Propensity-score matched non-cancer patients were identified from the SEMI-COVID registry. A lower proportion of patients were hospitalized in the later waves (54.2%) compared to the earlier (88.6%), OR 0.15, 95%CI 0.11–0.20. The proportion of hospitalized patients admitted to the ICU was higher in the later cohort (103/215, 47.9%) compared with the early cohort (170/681, 25.0%, 2.77; 2.01–3.82). The reduced 30-day mortality between early and later cohorts of non-cancer inpatients (29.6% vs. 12.6%, OR 0.34; 0.22–0.53) was not paralleled in inpatients with hematologic malignancies (32.3% vs. 34.8%, OR 1.12; 0.81–1.5). Among evaluable patients, 27.3% had post COVID-19 condition. These findings will help inform evidence-based preventive and therapeutic strategies for patients with hematologic malignancies and COVID-19 diagnosis.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

Reference36 articles.

1. (2022, September 07). WHO Coronavirus (COVID-19) Dashboard. Available online: https://covid19.who.int/.

2. Spanish Ministry of Health Social Services and Equality (2022, September 06). Madrid—The Evolution of the Coronavirus by Region. Available online: https://www.epdata.es/datos/evolucion-coronavirus-cada-comunidad/518/madrid/304.

3. (2022, September 06). Statistical Information for the Analysis of the Impact of the COVID-19 Crisis. Available online: https://www.ine.es/en/covid/covid_inicio_en.htm.

4. Improving survival of critical care patients with coronavirus disease 2019 in England: A national cohort study, March to June;Dennis;Crit. Care Med.,2020

5. Changes in COVID-19 in-hospital mortality in hospitalised adults in England over the first seven months of the pandemic: An observational study using administrative data;Gray;Lancet Reg. Health Eur.,2021

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