Division of Infectious Diseases, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Division of Hematology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2024 Oct 28;39(41):e263. doi: 10.3346/jkms.2024.39.e263.
Patients with hematologic malignancies exhibit persistent severe acute respiratory syndrome coronavirus 2 positivity over long periods after coronavirus disease 2019 (COVID-19) diagnosis. However, the frequency of, risk factors for, and prognosis of prolonged COVID-19 in immunocompromised patients remain unclear. Therefore, we investigated the long-term outcomes of COVID-19 in lymphoma patients and identified the associated factors and impact of prolonged COVID-19 on mortality.
A multicenter retrospective cohort study of 583 lymphoma patients was conducted in 3 tertiary hospitals in South Korea. Patients receiving lymphoma treatment who were quarantined after obtaining a diagnosis of COVID-19 by polymerase chain reaction (PCR) or antigen test from August 2021 to September 2022 were examined.
Overall, 115 patients (19.7%) were diagnosed with COVID-19. Among 77 patients with clinical data, 24 had prolonged COVID-19. Patients in the prolonged COVID-19 group showed higher rates of receiving rituximab maintenance therapy following bendamustine and rituximab (BR) treatment for follicular lymphoma. This group did not show significant differences in clinical presentation within 30 days of COVID-19 diagnosis; however, it showed higher rates of re-admission due to COVID-19 pneumonia compared with the non-prolonged COVID-19 group. BR treatment followed by rituximab maintenance therapy is one of the risk factors for persistent PCR positivity, delayed or persistent pneumonia, and COVID-19 related admission after quarantine period. Prolonged COVID-19 was an independent risk factor for 1-year mortality.
Prolonged COVID-19 was more frequent in lymphoma patients who received BR treatment followed by rituximab maintenance therapy and associated with unfavorable long-term outcomes and higher 1-year mortality.
患有血液恶性肿瘤的患者在 COVID-19（新冠肺炎）诊断后很长一段时间内持续出现严重急性呼吸系统综合征冠状病毒 2 阳性。然而，免疫功能低下患者 COVID-19 持续时间较长的频率、风险因素和预后仍不清楚。因此，我们研究了淋巴瘤患者 COVID-19 的长期结局，并确定了与 COVID-19 持续时间延长相关的因素以及 COVID-19 对死亡率的影响。
在韩国的 3 家三级医院进行了一项多中心回顾性队列研究，纳入了 583 名接受淋巴瘤治疗的患者。该研究纳入了自 2021 年 8 月至 2022 年 9 月通过聚合酶链反应（PCR）或抗原检测诊断 COVID-19 后接受隔离治疗的淋巴瘤患者。
总体而言，115 名患者（19.7%）被诊断为 COVID-19。在有临床数据的 77 名患者中，有 24 名患者 COVID-19 持续时间较长。在 COVID-19 持续时间较长的患者中，滤泡性淋巴瘤接受苯达莫司汀和利妥昔单抗（BR）治疗后接受利妥昔单抗维持治疗的比例更高。该组在 COVID-19 诊断后 30 天内的临床表现无显著差异；然而，与 COVID-19 非持续组相比，该组因 COVID-19 肺炎再次入院的比例更高。BR 治疗后进行利妥昔单抗维持治疗是 PCR 持续阳性、肺炎延迟或持续以及隔离期后 COVID-19 相关入院的风险因素之一。COVID-19 持续时间较长是 1 年死亡率的独立危险因素。
在接受 BR 治疗后进行利妥昔单抗维持治疗的淋巴瘤患者中，COVID-19 持续时间较长，与不良的长期结局和较高的 1 年死亡率相关。
