TY - JOUR
T1 - Outcomes of patients with hematologic malignancies and COVID-19
T2 - a systematic review and meta-analysis of 3377 patients
AU - Vijenthira, Abi
AU - Gong, Inna Y.
AU - Fox, Thomas A.
AU - Booth, Stephen
AU - Cook, Gordon
AU - Fattizzo, Bruno
AU - Martín-Moro, Fernando
AU - Razanamahery, Jerome
AU - Riches, John C.
AU - Zwicker, Jeff
AU - Patell, Rushad
AU - Vekemans, Marie Christiane
AU - Scarfò, Lydia
AU - Chatzikonstantinou, Thomas
AU - Yildiz, Halil
AU - Lattenist, Raphaël
AU - Mantzaris, Ioannis
AU - Wood, William A.
AU - Hicks, Lisa K.
N1 - Funding Information:
Conflict-of-interest disclosure: G.C. has received research funding from Takeda, Celgene, Janssen, and IQVIA, and has provided consultancy for Takeda, Celgene, Janssen, Sanofi, Amgen, Roche, and Karyopharm. B.F. has received consultation fees from Momenta Pharmaceuticals and Apellis SRL on autoimmune hemolytic anemia. J.Z. has received research funding from Incyte and Quercegen; has provided consultancy for Sanofi, CSL, and Parexel; and has received honoraria or served on advisory boards for Pfizer/Bristol Myers Squibb, Portola, and Dova. L.S. has received honoraria from AbbVie, AstraZeneca, Gilead, and Janssen. W.A.W. has received research funding from Pfizer and Genentech, is a consultant for Best Doctors/Teladoc, is an advisor for and holds equity in Koneksa Health and Elektra Labs, and has received honoraria from the ASH Research Collaborative. L.K.H. is co–principal investigator on a study partially funded by Gilead Sciences. The remaining authors declare no competing financial interests.
Publisher Copyright:
© 2020 by The American Society of Hematology.
PY - 2020/12/17
Y1 - 2020/12/17
N2 - Outcomes for patients with hematologic malignancy infected with COVID-19 have not been aggregated. The objective of this study was to perform a systematic review and meta-analysis to estimate the risk of death and other important outcomes for these patients. We searched PubMed and EMBASE up to 20 August 2020 to identify reports of patients with hematologic malignancy and COVID-19. The primary outcome was a pooled mortality estimate, considering all patients and only hospitalized patients. Secondary outcomes included risk of intensive care unit admission and ventilation in hospitalized patients. Subgroup analyses included mortality stratified by age, treatment status, and malignancy subtype. Pooled prevalence, risk ratios (RRs), and 95% confidence intervals (CIs) were calculated using a random-effects model. Thirty-four adult and 5 pediatric studies (3377 patients) from Asia, Europe, and North America were included (14 of 34 adult studies included only hospitalized patients). Risk of death among adult patients was 34% (95% CI, 28-39; N 5 3240) in this sample of predominantly hospitalized patients. Patients aged ‡60 years had a significantly higher risk of death than patients <60 years (RR, 1.82; 95% CI, 1.45-2.27; N 5 1169). The risk of death in pediatric patients was 4% (95% CI, 1-9; N 5 102). RR of death comparing patients with recent systemic anticancer therapy to no treatment was 1.17 (95% CI, 0.83-1.64; N 5 736). Adult patients with hematologic malignancy and COVID-19, especially hospitalized patients, have a high risk of dying. Patients ‡60 years have significantly higher mortality; pediatric patients appear to be relatively spared. Recent cancer treatment does not appear to significantly increase the risk of death.
AB - Outcomes for patients with hematologic malignancy infected with COVID-19 have not been aggregated. The objective of this study was to perform a systematic review and meta-analysis to estimate the risk of death and other important outcomes for these patients. We searched PubMed and EMBASE up to 20 August 2020 to identify reports of patients with hematologic malignancy and COVID-19. The primary outcome was a pooled mortality estimate, considering all patients and only hospitalized patients. Secondary outcomes included risk of intensive care unit admission and ventilation in hospitalized patients. Subgroup analyses included mortality stratified by age, treatment status, and malignancy subtype. Pooled prevalence, risk ratios (RRs), and 95% confidence intervals (CIs) were calculated using a random-effects model. Thirty-four adult and 5 pediatric studies (3377 patients) from Asia, Europe, and North America were included (14 of 34 adult studies included only hospitalized patients). Risk of death among adult patients was 34% (95% CI, 28-39; N 5 3240) in this sample of predominantly hospitalized patients. Patients aged ‡60 years had a significantly higher risk of death than patients <60 years (RR, 1.82; 95% CI, 1.45-2.27; N 5 1169). The risk of death in pediatric patients was 4% (95% CI, 1-9; N 5 102). RR of death comparing patients with recent systemic anticancer therapy to no treatment was 1.17 (95% CI, 0.83-1.64; N 5 736). Adult patients with hematologic malignancy and COVID-19, especially hospitalized patients, have a high risk of dying. Patients ‡60 years have significantly higher mortality; pediatric patients appear to be relatively spared. Recent cancer treatment does not appear to significantly increase the risk of death.
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U2 - 10.1182/blood.2020008824
DO - 10.1182/blood.2020008824
M3 - Review article
C2 - 33113551
AN - SCOPUS:85097992108
SN - 0006-4971
VL - 136
SP - 2881
EP - 2892
JO - Blood
JF - Blood
IS - 25
ER -
