SARS-CoV-2 infection among patients with haematological disorders: Severity and one-month outcome in 66 Danish patients in a nationwide cohort study

Eur J Haematol. 2021 Jan;106(1):72-81. doi: 10.1111/ejh.13519. Epub 2020 Sep 29.

Abstract

Objectives: Patients with haematological disorders may be particularly vulnerable to respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; however, this is unknown.

Methods: We conducted a prospective, nationwide study including 66 patients in follow-up at Danish haematology departments with a malignant or non-malignant haematological disorder and with verified SARS-CoV-2 infection. Outcomes were intensive care unit (ICU) admission and one-month survival rate.

Results: Mean age was 66.7 years, 60.6% were males, 90.9% had comorbidity, and 13.6% had a BMI ≥ 30. The most frequent diagnoses were chronic lymphocytic leukaemia/lymphoma (47.0%), multiple myeloma (16.7%) and acute leukaemia/myelodysplastic syndrome (AL/MDS) (12.1%). Treatment for the haematological disease was ongoing in 59.1% of cases. Neutropenia was present in 6.5%, lymphopenia in 46.6% and hypogammaglobulinaemia in 26.3%. The SARS-CoV-2 infection was mild in 50.0%, severe in 36.4% and critical in 13.6%. After one month, 21.2% had been admitted to ICU, and 24.2% died. Mortality was highest in older patients, patients with severe/critical SARS-CoV-2 infection, high comorbidity score or high performance status score, purine analogue treatment and with AL/MDS. Although older patients and patients with comorbidities had the highest mortality rates, mortality was considerable among all haematological patients.

Conclusion: Haematological patients with SARS-CoV-2 infection has a severe clinical course.

Keywords: immunology and infectious diseases.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / mortality*
  • COVID-19 / pathology
  • COVID-19 / therapy
  • Denmark / epidemiology
  • Female
  • Hematologic Neoplasms / mortality*
  • Hematologic Neoplasms / pathology
  • Hematologic Neoplasms / therapy
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • SARS-CoV-2*
  • Severity of Illness Index