key: cord-346268-6oufmmw6
authors: Infante, Maria‐Stefania; González‐Gascón y Marín, Isabel; Muñoz‐Novas, Carolina; Churruca, Juan; Foncillas, María‐Ángeles; Landete, Elena; Marín, Karen; Ryan, Pablo; Hernández‐Rivas, José‐Ángel
title: COVID‐19 in patients with hematological malignancies: A retrospective case series
date: 2020-08-04
journal: Int J Lab Hematol
DOI: 10.1111/ijlh.13301
sha: 
doc_id: 346268
cord_uid: 6oufmmw6

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PCR clearance, aiming to see if it was different from published data on nonhematological or cancer patients.

Statistical analysis was performed using SPSS 21.0 software package (SPSS). The Mann-Whitney test was done to compare quantitative variables. Odds ratio for mortality was calculated by logistic regression. Cox regression was used for univariate analysis of the impact of variables on overall survival (OS). These data were expressed as the hazard ratio (HR) with a 95% confidence interval (95% CI). A P-value < .05 was considered significant for all analyses. The local ethics committee approved the study (R 027-20).

The source of transmission was unknown in 4/41 (10%) cases.

Seven patients (17%) declared a direct contact with a COVID-19 positive family member. Nosocomial transmission was confirmed in 5/41 (15%) as they had been admitted for other reasons prior to the outbreak, and seemed likely in 25/41 patients (61%) who had attended the hematology day hospital in the previous 14 days.

These patients had been advised to go to the day hospital to receive blood products or due to a new hematological diagnosis or uncontrolled disease requiring therapy. The French group described a similar incidence of nosocomial COVID-19 in hematological patients. 6 Complete details of the entire cohort are shown in Table 1 None of the patients had undergone a previous hematopoietic stem cell transplantation (HSCT). All patients but three (93%) had additional chronic medical conditions. The median duration of symptoms before the SARS-CoV-2 PCR assay was performed was 5.6 (range 0-18) days.

Twenty-nine (70%) patients required hospitalization due to the severity of COVID-19, while 6 (15%) were treated as outpatients.

The severity of pneumonia according to WHO criteria was severe for the majority of the patients (73%, n = 30) and mild for the rest (15% n = 6). Only 5/41 (12%) patients developed ARDS, and all of them died despite ICU admission.

During the pandemic, an unusual number of thromboembolic complications have been described. 11 In our cohort, four patients were diagnosed with pulmonary embolism (PE) and one with arterial thrombosis (acrocyanosis of the limbs) after COVID-19 diagnosis, with a fatal outcome (4/5 died). Table 2 . These results are in line with the bad outcome observed in previous reports. [4] [5] [6] [7] [8] [9] However, these data need further validation due to the small simple size and the possible effect of confounding factors.

Moreover, we analyzed the relationship of clinical and laboratory findings with outcome. We observed that the severity of pneumonia was associated with increased risk of dying from COVID-19 in hema- We did not observe significant differences among laboratory findings and outcome either (Table 3) . However, although without significance, median hemoglobin, lymphocyte count, and platelet count were lower in patients with fatal outcome, while median IL-6, ferritin, D-dimer, and LDH were higher, as previously described in patients with COVID-19. 11 

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