Clinical characteristics, therapeutic management, and prognostic factors of adult COVID-19 inpatients with hematological malignancies

Abstract

Patients with hematological malignancies with immunodeficiency are at high risk for SARS-CoV-2 infection. We retrospective summarized clinical characteristics of coronavirus disease 2019 (COVID-19) inpatients with hematological malignancies, shared treatment experiences, and analysis prognostic factors. Fourteen patients were enrolled. The median duration of viral shedding was 27.5 days in survivors. The median duration of time to death was 13 days in non-survivors. Non-survivors tend to present lower neutrophil count, more imaging finding of bilateral diffuse patch opacities, more undergoing intensive chemotherapy or immunosuppression. Laboratory and image findings were atypical and diverse. COVID-19 inpatients undergoing intensive chemotherapy or immunosuppression might have increased risk of death. The diagnostic value of specific antibody detection is limited. Therefore, adult COVID-19 inpatients with hematological malignancies present atypical, severe symptoms, decreased virus clearance ability, abnormal antibody response and poor outcome. During the epidemic, the pros and cons need to be carefully weighed while selecting the treatment methods.

Keywords:

• COVID-19
• SARS-CoV-2
• hematological malignancies
• prognostic factor
• antibody response
• treatment

Acknowledgement

We acknowledge radiologists (Chuansheng Zheng, Bo Liang and Lian Yang) involved in the imaging assessment and we thank Mei Hong, Linghui Xia, Yaohui, Weiming Li, and Lingbo Liu (Institude of Hematology, Union Hospital, Wuhan, China) for providing cases. We would like to thank Editage (www.editage.cn) for English language editing.

Author contributions

YH and YWa had the idea for and designed the study, had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. YH, YWa, YW, WL, WC, HM, and MZ drafted the paper. YH, YWa, YW, WL, WC, MZ, HM, QW, and XZ did the analysis, and all authors critically revised the manuscript for important intellectual content and gave final approval for the version to be published. YW, WC, MZ, QW, and XZ collected the data. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This study was supported by a grant from the Key Special Project of Ministry of Science and Technology, China [No.2020YFC0845700].