Clinical manifestations and risk factors for COVID-19 and its severity in patients with hematological malignancies

Tzong-Yow Wu; Wan-Ting Tsai; Kai-Hsiang Chen; Szu-Ting Huang; Chun-Fu Huang; Po-Hsien Kuo; Ming-Jui Tsai; Wang-Da Liu; Kuan-Yin Lin; Yu-Shan Huang; Aristine Cheng; Pao-Yu Chen; Hsin-Yun Sun; Huai-Hsuan Huang; Tai-Chung Huang; Shang-Ju Wu; Ming Yao; Jann-Tay Wang; Wang-Huei Sheng; Chien-Ching Hung; Yee-Chun Chen; Shan-Chwen Chang

Journal of Microbiology, Immunology and Infection (Jun 2024)

Clinical manifestations and risk factors for COVID-19 and its severity in patients with hematological malignancies

Tzong-Yow Wu,
Wan-Ting Tsai,
Kai-Hsiang Chen,
Szu-Ting Huang,
Chun-Fu Huang,
Po-Hsien Kuo,
Ming-Jui Tsai,
Wang-Da Liu,
Kuan-Yin Lin,
Yu-Shan Huang,
Aristine Cheng,
Pao-Yu Chen,
Hsin-Yun Sun,
Huai-Hsuan Huang,
Tai-Chung Huang,
Shang-Ju Wu,
Ming Yao,
Jann-Tay Wang,
Wang-Huei Sheng,
Chien-Ching Hung,
Yee-Chun Chen,
Shan-Chwen Chang

Affiliations

Tzong-Yow Wu: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Wan-Ting Tsai: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, Taipei City Hospital, Zhongxiao Branch, Taipei, Taiwan
Kai-Hsiang Chen: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
Szu-Ting Huang: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
Chun-Fu Huang: Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan
Po-Hsien Kuo: Department of Internal Medicine, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
Ming-Jui Tsai: Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan
Wang-Da Liu: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medicine, National Taiwan University Cancer Center, Taipei, Taiwan; Corresponding author. Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Rd., Taipei City 10002, Taiwan.
Kuan-Yin Lin: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Yu-Shan Huang: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Aristine Cheng: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Pao-Yu Chen: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Hsin-Yun Sun: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Huai-Hsuan Huang: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Tai-Chung Huang: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Shang-Ju Wu: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Ming Yao: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Jann-Tay Wang: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Zhunan, Taiwan
Wang-Huei Sheng: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Medical Education, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Chien-Ching Hung: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan; Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan
Yee-Chun Chen: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Center of Infection Control, National Taiwan University Hospital, Taipei, Taiwan
Shan-Chwen Chang: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

Journal volume & issue: Vol. 57, no. 3
pp. 403 – 413

Abstract

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Background: Patients with hematological malignancies (HM) were at a high risk of developing severe disease from coronavirus disease 2019 (COVID-19). We aimed to assess the clinical outcome of COVID-19 in hospitalized patients with HM. Methods: Adult patients with HM who were hospitalized with a laboratory-confirmed COVID-19 between May, 2021 and November, 2022 were retrospectively identified. Primary outcome was respiratory failure requiring mechanical ventilation or mortality within 60 days after hospitalization. We also analyzed associated factors for de-isolation (defined as defervescence with a consecutive serial cycle threshold value > 30) within 28 days. Results: Of 152 eligible patients, 22 (14.5%) developed respiratory failure or mortality in 60 days. Factors associated with developing respiratory failure that required mechanical ventilation or mortality included receipt of allogeneic hematopoietic stem-cell transplantation (allo-HSCT) (adjusted hazards ratio [aHR], 5.10; 95% confidence interval [CI], 1.64–15.85), type 2 diabetes mellitus (aHR, 2.47; 95% CI, 1.04–5.90), lymphopenia at admission (aHR, 6.85; 95% CI, 2.45–19.15), and receiving <2 doses of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines (aHR, 3.00; 95% CI, 1.19–7.60). Ninety-nine (65.1%) patients were de-isolated in 28 days, against which two hazardous factors were identified: receipt of B-cell depletion therapies within one year prior to COVID-19 (aHR, 0.55, 95% CI, 0.35–0.87) and lymphopenia upon admission (aHR, 0.65; 95% CI, 0.43–1.00). Conclusion: We found a high rate of respiratory failure and mortality among patients with HM who contracted the SARS-CoV-2. Factors associated with developing respiratory failure or mortality in 60 days included receipt of allo-HSCT, type 2 diabetes mellitus and lymphopenia upon admission. Having received ≥2 doses of vaccination conferred protection against clinical progression.

Published in Journal of Microbiology, Immunology and Infection

ISSN: 1684-1182 (Print)
Publisher: Elsevier
Country of publisher: Hong Kong
LCC subjects: Science: Microbiology
Website: https://www.sciencedirect.com/journal/journal-of-microbiology-immunology-and-infection

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