{"title":"影响血液系统恶性肿瘤患者COVID-19预后的因素","authors":"A M Rudzite, D Auzina, S Lejniece","doi":"10.15407/exp-oncology.2024.03.260","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Patients with hematological malignancies (HM) are considered to have a high risk of developing severe and life-threatening infections including COVID-19 because of immune deficiency and immunosuppressive treatments. Although the COVID pandemic spread worldwide, morbidity and mortality data varied from country to country. A more accurate identification of risk factors would allow the improvement of the clinical management of HM patients.</p><p><strong>Aim: </strong>This study aimed to determine real-life data - the mortality rate, clinical outcomes, and risk factors affecting mortality in patients with HM and COVID-19 at the Riga East University Hospital (REUH) in Latvia.</p><p><strong>Materials and methods: </strong>In this retrospective non-interventional cohort study, we included adult patients treated in REUH with ongoing HM and laboratory- confirmed COVID-19 observed between December 1st, 2020, and March 31st, 2023. All data were analyzed using descriptive statistics, binary logistic regression, univariable Cox regression model, and other methods.</p><p><strong>Results: </strong>We registered 156 patients with 11 different HMs. Multiple myeloma, non-Hodgkin lymphoma, and acute myeloid leukemia were the most common HM. COVID-19 mortality rate was 19.9% (31/156). Factors increasing the risk of death included the severity of COVID-19 (p < 0.001), the accession of bacterial infection (p < 0.001), longer hospital stay (p = 0.037), absolute neutrophil count (ANC) ≤ 0.5 × 109/mm3 (p = 0.014), fever (p = 0.039), and acute myeloid leukemia (p = 0.002). We also confirmed that the mortality in the third pandemic wave was significantly lower than in the second wave (p = 0.002). Although vaccination seemed to be a risk-mitigating factor (58.8% [10/17] of those who died from COVID-19 were not vaccinated), no statistically important correlation was found (p = 0.690).</p><p><strong>Conclusion: </strong>This survey confirmed that the COVID-19 mortality rate was higher in patients with HM (19.9% [31/156]) than in the population. ANC, severity of COVID-19, accession of bacterial infection, hospital stay, fever, and acute myeloid leukemia were the factors that increased mortality in HM patients.</p>","PeriodicalId":94318,"journal":{"name":"Experimental oncology","volume":"46 3","pages":"260-267"},"PeriodicalIF":0.0000,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"FACTORS AFFECTING COVID-19 OUTCOMES IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES.\",\"authors\":\"A M Rudzite, D Auzina, S Lejniece\",\"doi\":\"10.15407/exp-oncology.2024.03.260\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Patients with hematological malignancies (HM) are considered to have a high risk of developing severe and life-threatening infections including COVID-19 because of immune deficiency and immunosuppressive treatments. Although the COVID pandemic spread worldwide, morbidity and mortality data varied from country to country. A more accurate identification of risk factors would allow the improvement of the clinical management of HM patients.</p><p><strong>Aim: </strong>This study aimed to determine real-life data - the mortality rate, clinical outcomes, and risk factors affecting mortality in patients with HM and COVID-19 at the Riga East University Hospital (REUH) in Latvia.</p><p><strong>Materials and methods: </strong>In this retrospective non-interventional cohort study, we included adult patients treated in REUH with ongoing HM and laboratory- confirmed COVID-19 observed between December 1st, 2020, and March 31st, 2023. All data were analyzed using descriptive statistics, binary logistic regression, univariable Cox regression model, and other methods.</p><p><strong>Results: </strong>We registered 156 patients with 11 different HMs. Multiple myeloma, non-Hodgkin lymphoma, and acute myeloid leukemia were the most common HM. COVID-19 mortality rate was 19.9% (31/156). Factors increasing the risk of death included the severity of COVID-19 (p < 0.001), the accession of bacterial infection (p < 0.001), longer hospital stay (p = 0.037), absolute neutrophil count (ANC) ≤ 0.5 × 109/mm3 (p = 0.014), fever (p = 0.039), and acute myeloid leukemia (p = 0.002). We also confirmed that the mortality in the third pandemic wave was significantly lower than in the second wave (p = 0.002). Although vaccination seemed to be a risk-mitigating factor (58.8% [10/17] of those who died from COVID-19 were not vaccinated), no statistically important correlation was found (p = 0.690).</p><p><strong>Conclusion: </strong>This survey confirmed that the COVID-19 mortality rate was higher in patients with HM (19.9% [31/156]) than in the population. ANC, severity of COVID-19, accession of bacterial infection, hospital stay, fever, and acute myeloid leukemia were the factors that increased mortality in HM patients.</p>\",\"PeriodicalId\":94318,\"journal\":{\"name\":\"Experimental oncology\",\"volume\":\"46 3\",\"pages\":\"260-267\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-12-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Experimental oncology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.15407/exp-oncology.2024.03.260\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Experimental oncology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15407/exp-oncology.2024.03.260","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
FACTORS AFFECTING COVID-19 OUTCOMES IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES.
Background: Patients with hematological malignancies (HM) are considered to have a high risk of developing severe and life-threatening infections including COVID-19 because of immune deficiency and immunosuppressive treatments. Although the COVID pandemic spread worldwide, morbidity and mortality data varied from country to country. A more accurate identification of risk factors would allow the improvement of the clinical management of HM patients.
Aim: This study aimed to determine real-life data - the mortality rate, clinical outcomes, and risk factors affecting mortality in patients with HM and COVID-19 at the Riga East University Hospital (REUH) in Latvia.
Materials and methods: In this retrospective non-interventional cohort study, we included adult patients treated in REUH with ongoing HM and laboratory- confirmed COVID-19 observed between December 1st, 2020, and March 31st, 2023. All data were analyzed using descriptive statistics, binary logistic regression, univariable Cox regression model, and other methods.
Results: We registered 156 patients with 11 different HMs. Multiple myeloma, non-Hodgkin lymphoma, and acute myeloid leukemia were the most common HM. COVID-19 mortality rate was 19.9% (31/156). Factors increasing the risk of death included the severity of COVID-19 (p < 0.001), the accession of bacterial infection (p < 0.001), longer hospital stay (p = 0.037), absolute neutrophil count (ANC) ≤ 0.5 × 109/mm3 (p = 0.014), fever (p = 0.039), and acute myeloid leukemia (p = 0.002). We also confirmed that the mortality in the third pandemic wave was significantly lower than in the second wave (p = 0.002). Although vaccination seemed to be a risk-mitigating factor (58.8% [10/17] of those who died from COVID-19 were not vaccinated), no statistically important correlation was found (p = 0.690).
Conclusion: This survey confirmed that the COVID-19 mortality rate was higher in patients with HM (19.9% [31/156]) than in the population. ANC, severity of COVID-19, accession of bacterial infection, hospital stay, fever, and acute myeloid leukemia were the factors that increased mortality in HM patients.