As COVID-19 persists around the world, health care professionals and researchers have had to examine what effects the disease may have on specific comorbidities. This is no different in the field of hematology.
While research is limited thus far, there have been some studies in the past year into the effects of COVID-19 on patients with hematologic malignancies. What do we know based on the limited information available?
Age Affects Risk
A 2020 study in Blood looked at the outcomes of patients with both hematologic malignancies and COVID-19, and found that patient age played a factor in mortality risk.¹ The researchers found that adult patients with COVID-19 and hematologic malignancies had a 34% risk of death. Conversely, pediatric patients had a mortality risk of just 4%. Patients 60 years and older were at a much greater mortality risk (47% compared to 25% in adult patients under the age of 60).
Odds of Getting COVID-19 Greater in Patients With Hematologic Malignancies
Some studies suggest that patients with hematologic malignancies not only are at a higher risk of mortality when diagnosed with COVID-19, but also at a higher risk for contracting the virus in the first place.
A 2021 study published in Blood Reviews focused on the risks, outcomes, and disparities in COVID-19 for patients with hematologic malignancies in the United States.² The researchers found that patients with both COVID-19 and hematologic malignancies had a 51.9% risk of hospitalization and a 14.8% mortality rate. These percentages were both higher than those of patients with COVID-19 but no hematologic malignancy (23.5% hospitalization risk and 5.1% mortality risk) and those with hematologic malignancies but no COVID-19 (15% hospitalization risk and 4.1% mortality risk).
The researchers also found that patients with hematologic malignancies had a higher risk for developing COVID-19; patients with acute lymphoid leukemia were particularly at risk.
Infection and Mortality Risk Vary By Demographic
The aforementioned study in Blood noted that non-white patients had a significantly higher mortality risk than white patients.¹ The researchers of the Blood Reviews study found similar demographic disparities.² Of patients with COVID-19 and recently diagnosed blood cancers, African Americans were at greater risk for death than white patients (6.8% vs 4.5%). The researchers also noted that women with essential thrombocythemia had lower odds of COVID-19 infection than men with the same condition. Women with non-Hodgkin lymphoma, however, had higher odds of being diagnosed with COVID-19 than their male counterparts.
Prognosis May Affect Outcomes
A separate study on COVID-19 and hematologic malignancies, this one published in Blood Advances in 2020, identified that prognosis of hematologic malignancies had an impact on patient outcomes.³ Of patients who were given a prognosis of 12 months or fewer prior to their COVID-19 diagnosis, 83% experienced moderate or severe COVID-19 symptoms compared with 67% of patients who were given a longer prognosis. The patients with a shorter prognosis also had a significantly higher mortality risk (62% vs 22%). Patients in a relapsed or refractory state of hematologic malignancy were also at increased risk; 82% experienced moderate to severe COVID-19 symptoms and 47% died.
1. Vijenthira A, Gong IY, Fox TA, et al. Outcomes of patients with hematologic malignancies and COVID-19: a systematic review and meta-analysis of 3377 patients. Blood. 2020;136(25):2881-2892. doi:10.1182/blood.2020008824
2. Wang Q, Berger NA, Xu R. When hematologic malignancies meet COVID-19 in the United States: infections, death and disparities. Blood Rev. 2021;47:100775. doi:10.1016/j.blre.2020.100775
3. Wood WA, Neuberg DS, Thompson JC, et al. Outcomes of patients with hematologic malignancies and COVID-19: a report from the ASH Research Collaborative Data Hub. Blood Adv. 2020;4(23):5966-5975. doi:10.1182/bloodadvances.2020003170