Department of Internal Medicine and Clinical Immunology, CHU La Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), 145 Boulevard Baille, Marseille, 13005, France.
Center for Cardiovascular and Nutrition Research (C2VN), INRA 1260, INSERM UMR_S 1263, Aix-Marseille University, Marseille, France.
Ann Hematol. 2021 Nov;100(11):2799-2803. doi: 10.1007/s00277-021-04656-z. Epub 2021 Sep 13.
Specificities of COVID-19 disease course in patients with haematologic malignancies are still poorly studied. So, we aimed to compare patients with haematologic malignancies to patients without malignancies, matched by sex and age and hospitalised for COVID-19 at the same time and in the same centre. Among 25 patients with haematologic malignancies, we found that mortality (40% versus 4%, p < 0.01), number of days with RT-PCR positivity (21.2 ± 15.9 days [range, 3-57] versus 7.4 ± 5.6 days [range, 1-24], p < 0.01), maximal viral load (mean minimal Ct, 17.2 ± 5.2 [range, 10-30] versus 26.5 ± 5.1 [range, 15-33], p < 0.0001) and the delay between symptom onset and clinical worsening (mean time duration between symptom onset and first day of maximum requirement in inspired oxygen fraction, 14.3 ± 10.7 days versus 9.6 ± 3.7 days, p = 0.0485) were higher than in other patients. COVID-19 course in patients with haematologic malignancies has a delayed onset and is more severe with a higher mortality, and patients may be considered as super-spreaders. Clinicians and intensivists need to be trained to understand the specificity of COVID-19 courses in patients with haematological malignancies.
COVID-19 疾病在血液病患者中的特点仍研究甚少。因此,我们旨在比较同时在同一中心因 COVID-19 住院的血液病患者和无恶性肿瘤的患者,这些患者按照性别和年龄相匹配。在 25 例血液病患者中,我们发现死亡率(40%比 4%,p<0.01)、RT-PCR 阳性天数(21.2±15.9 天[范围 3-57]比 7.4±5.6 天[范围 1-24],p<0.01)、最大病毒载量(平均最小 Ct 值,17.2±5.2[范围 10-30]比 26.5±5.1[范围 15-33],p<0.0001)和症状出现与临床恶化之间的时间延迟(症状出现到最大吸氧需求第一天的平均时间间隔,14.3±10.7 天比 9.6±3.7 天,p=0.0485)均高于其他患者。血液病患者的 COVID-19 病程延迟,更严重,死亡率更高,这些患者可能被认为是超级传播者。临床医生和重症监护医生需要接受培训,以了解血液病患者 COVID-19 病程的特殊性。