COVID-19 in patients with chronic lymphocytic leukemia: a Moscow observational study

Abstract

We describe a retrospective cohort, 156 patients with chronic lymphocytic leukemia (CLL) diagnosed with COVID-19, analyze factors associated with a severe disease course and the effects of various treatment regimens. Anti-SARS-CoV-2 IgG and IgM levels are significantly lower. Patients with CLL are more likely to have a severe course of COVID-19, with IL-6 levels acting as a consistent biomarker of disease severity. Ten patients had recurrent episodes, fatality rate of 20%. Overall survival did not differ between patients receiving ibrutinib monotherapy and anti-CD20 antibodies ± chemotherapy. It seems that the immunodeficiency inherent to CLL influences outcomes to a larger degree than does the treatment. Glucocorticoids are not associated with significant OS improvement whereas anti-cytokine compounds usage seemed to be beneficial in patients with mild pulmonary involvement. Our data attest to the necessity of reorganizing health care for patients with CLL. Early administration of effective antiviral compounds and tailored vaccination protocols are warranted.

Keywords:

• Chronic lymphocytic leukemia
• COVID-19
• specific antibody response
• anti-cytokine therapy
• glucocorticoid therapy

Acknowledgments

The authors would like to thank City Clinical Hospital No. 52 and Botkin City Hospital. We thank the patients who participated in the study, as well as the investigators and clinical research staff from the study centers.

Disclosure statement

The authors declare that they have no conflicts of interest.