Late 2019 marked the first appearance of the SARS-CoV-2 coronavirus, which triggered a global pandemic of the disease commonly known as COVID-19. Because COVID-19 is a new disease, its effects on patients with hematologic cancers (those of the blood, bone marrow, and lymph nodes) are not well understood.
In systematic reviews and analyses of scientific publications, researchers searched for reports of patients with both hematologic cancers and COVID-19. Their primary goal was to determine whether patients with hematologic cancers had a greater risk of death associated with COVID-19, but they also tried to estimate how many patients needed to be admitted to the intensive care unit (ICU), how many needed mechanical ventilation, and how many of those who were admitted to the hospital needed noninvasive breathing support. The risks of death were further analyzed by patient age, treatment status, and precise type of cancer.
Overall, 29 published studies were identified, which included 25 studies in adults and 4 studies in children. Together, these studies included a total of 1847 patients from China, Europe, the United Kingdom, and North America who were found to have both a hematologic cancer and COVID-19.
Most of these patients (83%) were found to have required hospitalization for their illness. Approximately 1 in every 4 adult patients (23%) who were hospitalized required ICU admission. One in 6 patients (16%) required mechanical ventilation and an equal number required noninvasive breathing support.
More than 1 of every 3 patients (36%) with a hematologic cancer and COVID-19 died, with the risk of death being slightly higher (40%) for those who needed to be hospitalized. When grouped by age, patients who were aged ≥60 years had a much higher risk of death (46%) than patients aged <60 years (26%). Children in this analysis were found to have the lowest risk of death at 4%.
All types of hematologic cancer were found to have high risks of death when patients also developed COVID-19. Rates ranged from 31% for patients with chronic lymphocytic leukemia to 57% for patients with acquired bone marrow dysfunction syndromes such as acquired aplastic anemia. Notably, having recent cancer treatment did not significantly affect the risks of dying in this analysis.
These data provide some of the first estimates of the risk of death for patients with both hematologic cancers and COVID-19 and highlight the continued need for protecting these patients from contracting COVID-19.
Reference
Vijenthira A, Gong I, Fox TA, et al. Outcomes of adult and pediatric patients with hematologic malignancies and COVID-19: a systematic review and meta-analysis of 1847 patients. Presented at the 62nd American Society for Hematology Annual Meeting and Exposition; December 7, 2020. Abstract 745.