Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Blood. 2022 Aug 4;140(5):445-450. doi: 10.1182/blood.2022016147.
Previous studies have shown that patients with chronic lymphocytic leukemia (CLL) and coronavirus disease 2019 (COVID-19) have high mortality rates. Infection with the Omicron variant has been described as a milder disease course in the general population. However, the outcome for immunocompromised patients has not previously been reported. In a cohort of patients with CLL tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at hospital test sites in the time periods before and after dominance of the Omicron variant, rates of hospitalizations and intensive care unit admissions declined significantly, whereas 30-day mortality remained as high as 23% in the period with dominance of the Omicron sublineage BA.2 variant. However, for a larger population-based cohort of patients with CLL (including the hospital cohort), 30-day mortality was 2%. Thus, patients with CLL with close hospital contacts and, in particular, those >70 years of age with 1 or more comorbidities should be considered for closer monitoring and preemptive antiviral therapy upon a positive SARS-CoV-2 test.
先前的研究表明，慢性淋巴细胞白血病 (CLL) 患者和 2019 年冠状病毒病 (COVID-19) 患者的死亡率较高。在普通人群中，感染奥密克戎变异株被描述为疾病较轻的病程。然而，免疫功能低下患者的预后尚未有报道。在奥密克戎变异株流行之前和之后的医院检测点对 CLL 患者进行严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 检测的患者队列中，住院和重症监护病房入院率显著下降，而在奥密克戎亚系 BA.2 流行期间，30 天死亡率仍高达 23%。然而，对于更大的基于人群的 CLL 患者队列（包括医院队列），30 天死亡率为 2%。因此，与医院有密切接触的 CLL 患者，特别是有 1 种或多种合并症且年龄 >70 岁的患者，应考虑密切监测，并在 SARS-CoV-2 检测呈阳性时进行预防性抗病毒治疗。
