Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality. The survey was supported by the Scientific Working Group Infection in Hematology of the European Hematology Association (EHA). Eligible for the analysis were adult patients with HM and laboratory-confirmed COVID-19 observed between March and December 2020. The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma n = 1084, myeloma n = 684 and chronic lymphoid leukemia n = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia n = 497 and myelodysplastic syndromes n = 279). Severe/critical COVID-19 was observed in 63.8% of patients (n = 2425). Overall, 2778 (73.1%) of the patients were hospitalized, 689 (18.1%) of whom were admitted to intensive care units (ICUs). Overall, 1185 patients (31.2%) died. The primary cause of death was COVID-19 in 688 patients (58.1%), HM in 173 patients (14.6%), and a combination of both COVID-19 and progressing HM in 155 patients (13.1%). Highest mortality was observed in acute myeloid leukemia (199/497, 40%) and myelodysplastic syndromes (118/279, 42.3%). The mortality rate significantly decreased between the first COVID-19 wave (March–May 2020) and the second wave (October–December 2020) (581/1427, 40.7% vs. 439/1773, 24.8%, p value < 0.0001). In the multivariable analysis, age, active malignancy, chronic cardiac disease, liver disease, renal impairment, smoking history, and ICU stay correlated with mortality. Acute myeloid leukemia was a higher mortality risk than lymphoproliferative diseases. This survey confirms that COVID-19 patients with HM are at high risk of lethal complications. However, improved COVID-19 prevention has reduced mortality despite an increase in the number of reported cases.

中文翻译：

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患有血液系统恶性肿瘤的成年患者中的 COVID-19 感染：欧洲血液学协会调查 (EPICOVIDEHA)

血液恶性肿瘤 (HM) 患者因 2019 年 SARS-CoV-2 疾病 (COVID-19) 死亡的风险很高。更好地了解不良结果的危险因素可能会改善这些患者的临床管理。因此，我们研究了患有 COVID-19 的 HM 患者的基线特征，并分析了死亡率的预测因素。该调查得到了欧洲血液学协会（EHA）血液学感染科学工作组的支持。符合分析条件的患者为 2020 年 3 月至 12 月期间观察到的 HM 和实验室确诊的 COVID-19 成年患者。研究样本包括 3801 例病例，以淋巴增殖性疾病（主要是非霍奇金淋巴瘤 n = 1084、骨髓瘤 n = 684 和慢性淋巴癌）为代表。白血病 n = 474）和骨髓增生性恶性肿瘤（主要是急性髓系白血病 n = 497 和骨髓增生异常综合征 n = 279）。63.8% 的患者 (n = 2425) 观察到严重/危重 COVID-19。总体而言，2778 名患者（73.1%）住院治疗，其中 689 名患者（18.1%）入住重症监护病房（ICU）。总体而言，1185 名患者（31.2%）死亡。688 名患者 (58.1%) 的主要原因是 COVID-19，173 名患者 (14.6%) 的主要原因是 HM，155 名患者 (13.1%) 的主要原因是 COVID-19 和进展性 HM。急性髓系白血病（199/497，40%）和骨髓增生异常综合征（118/279，42.3%）的死亡率最高。在第一波 COVID-19（2020 年 3 月至 5 月）和第二波（2020 年 10 月至 12 月）之间，死亡率显着下降（581/1427，40.7% vs. 439/1773，24.8%，p 值 < 0.0001）。在多变量分析中，年龄、活动性恶性肿瘤、慢性心脏病、肝病、肾功能损害、吸烟史和 ICU 与死亡率相关。急性髓系白血病的死亡风险高于淋巴增殖性疾病。这项调查证实，患有 HM 的 COVID-19 患者出现致命并发症的风险很高。然而，尽管报告病例数有所增加，但改进的 COVID-19 预防措施已降低了死亡率。