Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.
Department of Hematology, Eiju General Hospital, Tokyo, Japan.
Int J Hematol. 2024 Feb;119(2):183-195. doi: 10.1007/s12185-023-03685-w. Epub 2024 Jan 3.
The Japanese Society of Hematology performed an observational cross-sectional study to clarify the morbidity, prognosis, and prognostic factors in patients with COVID-19 with hematological diseases (HDs) in Japan. The study included patients with HDs who enrolled in our epidemiological survey and had a COVID-19 diagnosis and a verified outcome of up to 2 months. The primary endpoints were characteristics and short-term prognosis of COVID-19 in patients with HDs. A total of 367 patients from 68 institutes were enrolled over 1 year, and the collected data were analyzed. The median follow-up among survivors was 73 days (range, 1-639 days). The 60-day overall survival (OS) rate was 86.6%. In the multivariate analysis, albumin ≤ 3.3 g/dL and a need for oxygen were independently associated with inferior 60-day OS rates (hazard ratio [HR] 4.026, 95% confidence interval (CI) 1.954-8.294 and HR 14.55, 95% CI 3.378-62.64, respectively), whereas 60-day survival was significantly greater in patients with benign rather than malignant disease (HR 0.095, 95% CI 0.012-0.750). Together, these data suggest that intensive treatment may be necessary for patients with COVID-19 with malignant HDs who have low albumin levels and require oxygen at the time of diagnosis.
日本血液学会进行了一项观察性横断面研究，旨在阐明日本 COVID-19 合并血液病（HDs）患者的发病率、预后和预后因素。该研究纳入了参加我们流行病学调查且 COVID-19 诊断明确、随访至 2 个月的 HDs 患者。主要终点是 COVID-19 在 HDs 患者中的特征和短期预后。在 1 年时间内，来自 68 个机构的 367 名患者入组，对收集的数据进行了分析。幸存者的中位随访时间为 73 天（范围为 1-639 天）。60 天总生存率（OS）为 86.6%。在多变量分析中，白蛋白≤3.3g/dL 和需要吸氧与较差的 60 天 OS 率独立相关（风险比[HR]4.026，95%置信区间[CI]1.954-8.294 和 HR 14.55，95% CI 3.378-62.64），而良性疾病患者的 60 天生存率明显高于恶性疾病患者（HR 0.095，95% CI 0.012-0.750）。这些数据表明，对于 COVID-19 合并恶性 HDs 且白蛋白水平低和诊断时需要吸氧的患者，可能需要强化治疗。
