Supervisors info:
Γκίκας Μαγιορκίνης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μιχαήλ Σαμάρκος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ευαγγελία Γεωργία Κωστάκη, Βιοστατιστικός PhD, Ιατρική Σχολή, ΕΚΠΑ
Summary:
Objectives: Patients with hematological malignancies are at higher risk for severe COVID-19 and exhibit worse outcomes compared to patients without hematological diseases. This study aimed to investigate possible prognostic factors regarding the outcome of COVID-19 in this specific population.
Methods: The population of this retrospective cohort study consisted of patients with hematological malignancies, hospitalized due to SARS-CoV-2 infection between June 2020 and June 2022. Individuals’ demographics, clinical and laboratory data were collected. The primary endpoint was 30-day mortality, while the secondary endpoint was the diagnosis of bacterial superinfection. Data were statistically analyzed with logistic regression.
Results: The study included 87 patients, with 50 (57.5%) males, and a median age of 65 years. 30-day mortality was calculated at 25.3% and 22 patients (25.3%) were diagnosed with bacterial superinfections during hospitalization. The rates of diabetes mellitus and acute leukemia were both higher among deceased patients (36.4% versus 9.2%, p=0.006, and 45.5% versus 23.1%, p=0.044, respectively). Multivariable logistic regression analysis showed that increase of the age [per year – OR 1.058 (95%CI 1.007,1.112)], CRP value [per 10 mg/L – OR 1.094 (95%CI 1.002,1.116)], and ferritin value [per 100 ng/mL – OR 1.017 (95%CI 1.001,1.034)], were independently associated with higher mortality. Additionally, severe neutropenia [OR 8.856 (95%CI 1.731,45.313)] and ferritin value [per 100 ng/mL - OR 1.024 (95%CI 1.004,1.043)] were statistically associated with the diagnosis of bacterial superinfection. Finally, patients with superinfections had a significantly higher mortality rate (50% versus 16.9%, p=0.003).
Conclusions: Early recognition of patients with hematological malignancies at high risk of severe COVID-19, as well as bacterial superinfections, is critical to optimize treatment for this specific population. According to the results of this study, older individuals, with higher CRP and ferritin values are at higher risk of death, while patients with severe neutropenia and elevated ferritin levels demonstrate higher incidence of superinfections and, therefore, worse prognosis.
Keywords:
COVID-19, Hematological malignancies, Prognostic factors, Mortality, Superinfection
