National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People's Hospital, Peking University Institute of Hematology, Peking University, Beijing, China.
Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.
Br J Haematol. 2023 Jul;202(1):31-39. doi: 10.1111/bjh.18823. Epub 2023 Apr 24.
As the COVID-19 variant Omicron surge in Beijing, China, a better understanding of risk factors for adverse outcomes may improve clinical management in patients with haematological malignancies (HM) diagnosed with COVID-19. The study sample includes 412 cases, mainly represented by acute leukaemia, chronic myeloid leukaemia (CML), plasma cell disorders and lymphoma and chronic lymphocytic leukaemia. COVID-19 pneumonia was observed in 10.4% (43/412) of patients, and severe/critical illness was observed in 5.3% (22/412). Among the 86 cases with advanced malignancies, 17.6% (12/86) of patients developed severe/critical COVID-19, which was significantly higher than reported in patients with stable malignancies (9/326, 2.70%, p < 0.001). Similarly, the advanced malignancy cohort had a higher mortality rate (9/86, 10.5% vs. 0/326, 0%, p < 0.001) and a poor 30-day overall survival (OS) compared with the stable malignancy cohort (74.2% vs. 100.0%, p < 0.0001). Overall, nine patients (2.2%) died. The primary cause of death was progressive HM in four patients and a combination of both COVID-19 and HM in five patients. In the multivariable analysis, over 65 years of age, comorbidities and advanced malignancy were correlated with severe/critical COVID-19 in HM patients. This study sheds light on the poor outcomes among COVID-19 HM patients with the leading cause of advanced malignancy.
随着中国北京 COVID-19 变异株奥密克戎的激增,更好地了解不良结局的危险因素可能会改善确诊 COVID-19 的血液恶性肿瘤 (HM) 患者的临床管理。研究样本包括 412 例病例,主要由急性白血病、慢性髓性白血病 (CML)、浆细胞疾病和淋巴瘤以及慢性淋巴细胞白血病组成。412 例患者中观察到 COVID-19 肺炎 10.4%(43/412),重症/危重症 5.3%(22/412)。在 86 例晚期恶性肿瘤患者中,17.6%(12/86)的患者发生严重/危重症 COVID-19,明显高于稳定期恶性肿瘤患者(9/326,2.70%,p<0.001)。同样,晚期恶性肿瘤组的死亡率(9/86,10.5%比 0/326,0%,p<0.001)和较差的 30 天总生存率(OS)也高于稳定期恶性肿瘤组(74.2%比 100.0%,p<0.0001)。总体而言,有 9 例患者(2.2%)死亡。死亡的主要原因是 4 例患者 HM 进展,5 例患者 COVID-19 和 HM 并存。多变量分析显示,65 岁以上、合并症和晚期恶性肿瘤与 HM 患者的严重/危重症 COVID-19 相关。本研究揭示了 COVID-19 HM 患者中晚期恶性肿瘤为主的不良结局。