Impact of COVID-19 on Hematologic Disorders: Clinical Insights and Challenges

Abstract

Introduction: Early studies indicated that patients with cancer had substantially elevated risks of undesirable coronavirus disease-2019 (COVID-19) outcomes, especially higher mortality rates. There are several reports that not all hematological malignancies have a fatality risk. We aim to contribute to the literature by evaluating patients diagnosed with COVID-19 during the pandemic in the field of hematology. Methods: This single-center, retrospective, cohort study included adult patients (aged ≥18 years) with COVID-19 who had a World Health Organization-defined hematological malignancy or non-neoplastic hematologic disorder and were admitted to İstanbul University, İstanbul Faculty of Medicine between March 2020 and May 2023. The primary outcome was mortality. We also evaluated the outcomes according to the type of hematologic disorder, age, disease status at the time of COVID-19 diagnosis, severity of COVID-19, comorbidities, and vaccination status. Treatment modalities were also collected. Statistical analysis was performed using StataMP 17. Results: We enrolled 285 patients. The median age was 57 years, and male predominance (55%). Fifty-one (17.89%) patients died. Patients aged ≥65 years were at increased risk of death (p<0.001). The mortality rate was significantly higher in patients with lymphoid malignancy, especially those with chronic lymphocytic leukemia (CLL) (p<0.001). In the multivariate analysis, the need for anakinra administration, intubation, and COVID-19 progression increased the risk of death. Conclusion: Hematologic patients are susceptible to COVID-19. Elderly individuals with active hematological disease are particularly at risk. Patients with CLL should be closely monitored. The need for anakinra, intubation, and COVID-19 progression increased the risk of death.

Keywords

• chronic lymphocytic leukemia
• hematological malignancy
• sars-cov-2