Tzong-Yow Wu , Wan-Ting Tsai , Kai-Hsiang Chen , Szu-Ting Huang , Chun-Fu Huang , Po-Hsien Kuo , Ming-Jui Tsai , Wang-Da Liu , Kuan-Yin Lin , Yu-Shan Huang , Aristine Cheng , Pao-Yu Chen , Hsin-Yun Sun , Huai-Hsuan Huang , Tai-Chung Huang , Shang-Ju Wu , Ming Yao , Jann-Tay Wang , Wang-Huei Sheng , Chien-Ching Hung , Shan-Chwen Chang
{"title":"血液恶性肿瘤患者 COVID-19 的临床表现和风险因素及其严重程度","authors":"Tzong-Yow Wu , Wan-Ting Tsai , Kai-Hsiang Chen , Szu-Ting Huang , Chun-Fu Huang , Po-Hsien Kuo , Ming-Jui Tsai , Wang-Da Liu , Kuan-Yin Lin , Yu-Shan Huang , Aristine Cheng , Pao-Yu Chen , Hsin-Yun Sun , Huai-Hsuan Huang , Tai-Chung Huang , Shang-Ju Wu , Ming Yao , Jann-Tay Wang , Wang-Huei Sheng , Chien-Ching Hung , Shan-Chwen Chang","doi":"10.1016/j.jmii.2024.03.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Patients with hematological malignancies (HM) were at a high risk of developing severe disease from coronavirus disease 2019 (COVID-19). We aimed to assess the clinical outcome of COVID-19 in hospitalized patients with HM.</p></div><div><h3>Methods</h3><p>Adult patients with HM who were hospitalized with a laboratory-confirmed COVID-19 between May, 2021 and November, 2022 were retrospectively identified. Primary outcome was respiratory failure requiring mechanical ventilation or mortality within 60 days after hospitalization. We also analyzed associated factors for de-isolation (defined as defervescence with a consecutive serial cycle threshold value > 30) within 28 days.</p></div><div><h3>Results</h3><p>Of 152 eligible patients, 22 (14.5%) developed respiratory failure or mortality in 60 days. Factors associated with developing respiratory failure that required mechanical ventilation or mortality included receipt of allogeneic hematopoietic stem-cell transplantation (allo-HSCT) (adjusted hazards ratio [aHR], 5.10; 95% confidence interval [CI], 1.64–15.85), type 2 diabetes mellitus (aHR, 2.47; 95% CI, 1.04–5.90), lymphopenia at admission (aHR, 6.85; 95% CI, 2.45–19.15), and receiving <2 doses of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines (aHR, 3.00; 95% CI, 1.19–7.60). Ninety-nine (65.1%) patients were de-isolated in 28 days, against which two hazardous factors were identified: receipt of B-cell depletion therapies within one year prior to COVID-19 (aHR, 0.55, 95% CI, 0.35–0.87) and lymphopenia upon admission (aHR, 0.65; 95% CI, 0.43–1.00).</p></div><div><h3>Conclusion</h3><p>We found a high rate of respiratory failure and mortality among patients with HM who contracted the SARS-CoV-2. Factors associated with developing respiratory failure or mortality in 60 days included receipt of allo-HSCT, type 2 diabetes mellitus and lymphopenia upon admission. Having received ≥2 doses of vaccination conferred protection against clinical progression.</p></div>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":"57 3","pages":"Pages 403-413"},"PeriodicalIF":4.5000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1684118224000471/pdfft?md5=22b7056e92e75f4229ff425753c9d663&pid=1-s2.0-S1684118224000471-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Clinical manifestations and risk factors for COVID-19 and its severity in patients with hematological malignancies\",\"authors\":\"Tzong-Yow Wu , Wan-Ting Tsai , Kai-Hsiang Chen , Szu-Ting Huang , Chun-Fu Huang , Po-Hsien Kuo , Ming-Jui Tsai , Wang-Da Liu , Kuan-Yin Lin , Yu-Shan Huang , Aristine Cheng , Pao-Yu Chen , Hsin-Yun Sun , Huai-Hsuan Huang , Tai-Chung Huang , Shang-Ju Wu , Ming Yao , Jann-Tay Wang , Wang-Huei Sheng , Chien-Ching Hung , Shan-Chwen Chang\",\"doi\":\"10.1016/j.jmii.2024.03.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Patients with hematological malignancies (HM) were at a high risk of developing severe disease from coronavirus disease 2019 (COVID-19). We aimed to assess the clinical outcome of COVID-19 in hospitalized patients with HM.</p></div><div><h3>Methods</h3><p>Adult patients with HM who were hospitalized with a laboratory-confirmed COVID-19 between May, 2021 and November, 2022 were retrospectively identified. Primary outcome was respiratory failure requiring mechanical ventilation or mortality within 60 days after hospitalization. We also analyzed associated factors for de-isolation (defined as defervescence with a consecutive serial cycle threshold value > 30) within 28 days.</p></div><div><h3>Results</h3><p>Of 152 eligible patients, 22 (14.5%) developed respiratory failure or mortality in 60 days. Factors associated with developing respiratory failure that required mechanical ventilation or mortality included receipt of allogeneic hematopoietic stem-cell transplantation (allo-HSCT) (adjusted hazards ratio [aHR], 5.10; 95% confidence interval [CI], 1.64–15.85), type 2 diabetes mellitus (aHR, 2.47; 95% CI, 1.04–5.90), lymphopenia at admission (aHR, 6.85; 95% CI, 2.45–19.15), and receiving <2 doses of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines (aHR, 3.00; 95% CI, 1.19–7.60). Ninety-nine (65.1%) patients were de-isolated in 28 days, against which two hazardous factors were identified: receipt of B-cell depletion therapies within one year prior to COVID-19 (aHR, 0.55, 95% CI, 0.35–0.87) and lymphopenia upon admission (aHR, 0.65; 95% CI, 0.43–1.00).</p></div><div><h3>Conclusion</h3><p>We found a high rate of respiratory failure and mortality among patients with HM who contracted the SARS-CoV-2. Factors associated with developing respiratory failure or mortality in 60 days included receipt of allo-HSCT, type 2 diabetes mellitus and lymphopenia upon admission. Having received ≥2 doses of vaccination conferred protection against clinical progression.</p></div>\",\"PeriodicalId\":56117,\"journal\":{\"name\":\"Journal of Microbiology Immunology and Infection\",\"volume\":\"57 3\",\"pages\":\"Pages 403-413\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S1684118224000471/pdfft?md5=22b7056e92e75f4229ff425753c9d663&pid=1-s2.0-S1684118224000471-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Microbiology Immunology and Infection\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1684118224000471\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Microbiology Immunology and Infection","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1684118224000471","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Clinical manifestations and risk factors for COVID-19 and its severity in patients with hematological malignancies
Background
Patients with hematological malignancies (HM) were at a high risk of developing severe disease from coronavirus disease 2019 (COVID-19). We aimed to assess the clinical outcome of COVID-19 in hospitalized patients with HM.
Methods
Adult patients with HM who were hospitalized with a laboratory-confirmed COVID-19 between May, 2021 and November, 2022 were retrospectively identified. Primary outcome was respiratory failure requiring mechanical ventilation or mortality within 60 days after hospitalization. We also analyzed associated factors for de-isolation (defined as defervescence with a consecutive serial cycle threshold value > 30) within 28 days.
Results
Of 152 eligible patients, 22 (14.5%) developed respiratory failure or mortality in 60 days. Factors associated with developing respiratory failure that required mechanical ventilation or mortality included receipt of allogeneic hematopoietic stem-cell transplantation (allo-HSCT) (adjusted hazards ratio [aHR], 5.10; 95% confidence interval [CI], 1.64–15.85), type 2 diabetes mellitus (aHR, 2.47; 95% CI, 1.04–5.90), lymphopenia at admission (aHR, 6.85; 95% CI, 2.45–19.15), and receiving <2 doses of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines (aHR, 3.00; 95% CI, 1.19–7.60). Ninety-nine (65.1%) patients were de-isolated in 28 days, against which two hazardous factors were identified: receipt of B-cell depletion therapies within one year prior to COVID-19 (aHR, 0.55, 95% CI, 0.35–0.87) and lymphopenia upon admission (aHR, 0.65; 95% CI, 0.43–1.00).
Conclusion
We found a high rate of respiratory failure and mortality among patients with HM who contracted the SARS-CoV-2. Factors associated with developing respiratory failure or mortality in 60 days included receipt of allo-HSCT, type 2 diabetes mellitus and lymphopenia upon admission. Having received ≥2 doses of vaccination conferred protection against clinical progression.
期刊介绍：
Journal of Microbiology Immunology and Infection is an open access journal, committed to disseminating information on the latest trends and advances in microbiology, immunology, infectious diseases and parasitology. Article types considered include perspectives, review articles, original articles, brief reports and correspondence.
With the aim of promoting effective and accurate scientific information, an expert panel of referees constitutes the backbone of the peer-review process in evaluating the quality and content of manuscripts submitted for publication.
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