{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"Research Square"}],"indexed":{"date-parts":[[2024,3,3]],"date-time":"2024-03-03T14:05:24Z","timestamp":1709474724649},"posted":{"date-parts":[[2020,9,2]]},"group-title":"In Review","reference-count":0,"publisher":"Research Square Platform LLC","license":[{"start":{"date-parts":[[2020,9,2]],"date-time":"2020-09-02T00:00:00Z","timestamp":1599004800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2020,8,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:p><jats:bold>Background <\/jats:bold>Patients with cancer have been shown to have a higher risk of clinical severity and mortality compared to non-cancer patients with COVID-19. Patients with hematologic malignancies typically are known to have higher levels of immunosuppression and may develop more severe respiratory viral infections than patients with solid tumours. Data on COVID-19 in patients with hematologic malignancies are limited. Here we characterise disease severity and mortality, and evaluate potential prognostic factors for mortality.<jats:bold>Methods <\/jats:bold>In this population-based registry study, we collected de-identified data on clinical characteristics, treatment and outcomes in adult patients with hematologic malignancies and confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection within the Madrid region of Spain. Our case series included all patients admitted to 22 regional health service hospitals and 5 private healthcare centres between February 28 and May 25, 2020. The primary study outcome was all-cause mortality. We assessed the association between mortality and potential prognostic factors using Cox regression analyses adjusted for age, sex, comorbidities, hematologic malignancy and recent active cancer therapy.<jats:bold>Results <\/jats:bold>Of 833 patients reported, 697 were included in the analyses. Median age was 72 years (IQR 60\u201379), 413 (60%) patients were male, and 479 (69%) and 218 (31%) had lymphoid and myeloid malignancies, respectively. Clinical severity of COVID-19 was severe\/critical in 429 (62%) patients. At data cutoff, 230 (33%) patients had died. Age \u226560 years (hazard ratios 3\u00b717\u201310\u00b71 <jats:italic>vs<\/jats:italic> &lt;50 years), &gt;2 comorbidities (1\u00b741 <jats:italic>vs<\/jats:italic> \u22642), acute myeloid leukemia (2\u00b722 <jats:italic>vs<\/jats:italic> non-Hodgkin lymphoma) and active antineoplastic treatment with monoclonal antibodies (2\u00b702) or conventional chemotherapy (1\u00b750 <jats:italic>vs <\/jats:italic>no active therapy) were associated with increased mortality. Conversely, Ph-negative myeloproliferative neoplasms (0\u00b733) and active treatment with hypomethylating agents (0\u00b747) were associated with lower mortality. Overall, 574 (82%) patients received antiviral therapy. Mortality with severe\/critical COVID-19 was higher with no therapy <jats:italic>vs<\/jats:italic> any antiviral combination therapy (2.20).<jats:bold>Conclusions <\/jats:bold>In this series of patients with hematologic malignancies and COVID-19, mortality was associated with higher age, more comorbidities, type of hematological malignancy and type of antineoplastic therapy. Further studies and long-term follow-up are required to validate these criteria for risk-stratification.<\/jats:p>","DOI":"10.21203\/rs.3.rs-69133\/v1","type":"posted-content","created":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T22:43:30Z","timestamp":1599173010000},"source":"Crossref","is-referenced-by-count":1,"title":["Impact of hematologic malignancy and type of cancer therapy on COVID-19 severity and mortality: lessons from a large population-based registry study"],"prefix":"10.21203","author":[{"given":"Julio","family":"Garc\u00eda-Su\u00e1rez*","sequence":"first","affiliation":[{"name":"Hematology Department, University Hospital Pr\u00edncipe de Asturias, Alcal\u00e1 de Henares, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier de la","family":"Cruz*","sequence":"additional","affiliation":[{"name":"Research Institute imas12, University Hospital 12 de Octubre, Madrid, SAMID-ISCIII, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1ngel","family":"Cedillo","sequence":"additional","affiliation":[{"name":"Asociaci\u00f3n Madrile\u00f1a de Hematolog\u00eda y Hemoterapia (AMHH), Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar","family":"Llamas","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Fundaci\u00f3n Jim\u00e9nez D\u00edaz, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Duarte","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Puerta de Hierro Majadahonda, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V\u00edctor","family":"Jim\u00e9nez-Yuste","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital La Paz, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 \u00c1ngel","family":"Hern\u00e1ndez-Rivas","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Infanta Leonor, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Gil-Manso","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital 12 de Octubre, imas12, Complutense University, CNIO-ISCIII, CIBERONC, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mi","family":"Kwon","sequence":"additional","affiliation":[{"name":"Hematology Department, University General Hospital Gregorio Mara\u00f1\u00f3n, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Department of Medicine, Complutense University, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"S\u00e1nchez-Godoy","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Severo Ochoa, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar","family":"Mart\u00ednez-Barranco","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Fundaci\u00f3n Alcorc\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blanca","family":"Col\u00e1s-Lahuerta","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Fundaci\u00f3n Alcorc\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar","family":"Herrera","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Ram\u00f3n y Cajal, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurentino","family":"Benito-Parra","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Getafe, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adri\u00e1n","family":"Alegre","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital La Princesa, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Velasco","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Rey Juan Carlos, M\u00f3stoles, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arturo","family":"Matilla","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Central de la Defensa G\u00f3mez Ulla, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Concepci\u00f3n","family":"Al\u00e1ez-Us\u00f3n","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital HLA Moncloa, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Martos-Mart\u00ednez","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Villalba, Villalba, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Mart\u00ednez-Chamorro","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Quir\u00f3nsalud, Pozuelo de Alarc\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keina","family":"Susana-Quiroz","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital M\u00f3stoles, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Francisco Del","family":"Campo","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Henares, Coslada, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adolfo de la","family":"Fuente","sequence":"additional","affiliation":[{"name":"Hematology Department, MD Anderson Cancer Center Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Regina","family":"Herr\u00e1ez","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Infanta Sof\u00eda, San Sebasti\u00e1n de los Reyes, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana","family":"Pascual","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Infanta Elena, Valdemoro, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elvira","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Sureste, Arganda del Rey, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaime","family":"P\u00e9rez-Oteyza","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital HM Sanchinarro, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Ruiz","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Tajo, Aranjuez, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arancha","family":"Alonso","sequence":"additional","affiliation":[{"name":"Hematology Department, Hospital Ruber, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Gonz\u00e1lez-Medina","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Fundaci\u00f3n Jim\u00e9nez D\u00edaz, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc\u00eda N\u00fa\u00f1ez","family":"Mart\u00edn-Buitrago","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Puerta de Hierro Majadahonda, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel","family":"Canales","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital La Paz, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Gonz\u00e1lez-Gasc\u00f3n","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Infanta Leonor, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Carmen","family":"Vicente-Ayuso","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Severo Ochoa, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susana","family":"Valenciano","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Pr\u00edncipe de Asturias, Alcal\u00e1 de Henares, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Garc\u00eda","family":"Roa","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Fundaci\u00f3n Alcorc\u00f3n, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo Estival","family":"Monteliu","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Cl\u00ednico San Carlos, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"L\u00f3pez-Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Ram\u00f3n y Cajal, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristi\u00e1n Escolano","family":"Escobar","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Getafe, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Ortiz-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital La Princesa, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Luis","family":"Diez-Martin\u2020","sequence":"additional","affiliation":[{"name":"Hematology Department, University General Hospital Gregorio Mara\u00f1\u00f3n, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Department of Medicine, Complutense University, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joaqu\u00edn","family":"Mart\u00ednez-L\u00f3pez\u2020","sequence":"additional","affiliation":[{"name":"Hematology 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