Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark.
Department of Haematology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Eur J Haematol. 2023 Dec;111(6):946-950. doi: 10.1111/ejh.14108. Epub 2023 Sep 22.
We aimed to quantify the risk of death following a positive test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among individuals with haematological malignancies, stratified by virus variants and type of malignancy.
Using the Danish nationwide registries, we conducted a population-based cohort study among individuals who received a discharge diagnosis of haematological malignancies during the 5 years prior to testing positive for SARS-CoV-2 (February 2020-April 2023). All individuals were followed for 30 days after a positive test, and overall and time-stratified case fatality risks (CFR) were estimated.
We identified 7154 individuals with a history of haematological malignancies who tested positive for SARS-CoV-2. Among these, we observed 223 deaths, yielding a CFR of 3.1%. The CFR was highest at the beginning of the pandemic (10%) and gradually declined to 1.9% during the period of Omicron BA1/BA2 predominance. The highest CFR was observed among individuals with acute leukaemia (CFR 6.2%, adjusted relative risk 1.95, 95% confidence interval 1.33-2.88) compared to individuals with lymphoma (CFR 3%).
We observed a reduction in the CFR over time, which may be attributed to new treatments, COVID-19 vaccination and the emergence of less aggressive variants.
我们旨在量化血液恶性肿瘤患者 SARS-CoV-2 检测阳性后死亡的风险，按病毒变异体和恶性肿瘤类型分层。
使用丹麦全国性登记处，我们对在 2020 年 2 月至 2023 年 4 月期间 SARS-CoV-2 检测阳性前 5 年内接受血液恶性肿瘤出院诊断的个体进行了一项基于人群的队列研究。所有个体均在 SARS-CoV-2 检测阳性后 30 天内进行随访，并估计了总体和时间分层的病死率（CFR）。
我们确定了 7154 名有血液恶性肿瘤史的个体 SARS-CoV-2 检测阳性。在这些个体中，我们观察到 223 例死亡，病死率为 3.1%。在大流行初期，病死率最高（10%），随着 Omicron BA1/BA2 占主导地位，病死率逐渐下降至 1.9%。在急性白血病患者中，病死率最高（CFR 6.2%，调整后相对风险 1.95，95%置信区间 1.33-2.88），与淋巴瘤患者（CFR 3%）相比。
我们观察到病死率随时间的推移而降低，这可能归因于新的治疗方法、COVID-19 疫苗接种和侵袭性较弱变异体的出现。
