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The authors of this systematic review and meta-analysis evaluated the outcomes of over 3000 patients with hematologic malignancies and COVID-19. The risks of death for adult and pediatric patients were 34% and 4%, respectively. Among adult patients, the risk of death was higher among those aged ≥60 years compared with those <60 years of age. Active systemic anti-cancer treatment did not significantly impact the risk of death in this study.
Elderly patients with hematologic malignancies and COVID-19 have a high mortality risk; pediatric patients have a much lower risk.
– Paul J. Hampel, MD
This abstract is available on the publisher's site.
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 August 20, 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 ICU admission and ventilation in hospitalized patients. Subgroup analyses included mortality stratified by age, treatment status, and malignancy subtype. Pooled prevalence, risk ratios (RR), and 95% confidence intervals (CI) were calculated using a random-effects model. 34 adult and 5 pediatric studies (3377 patients) from Asia, Europe, and North America were included (14/34 adult studies included only hospitalized patients). The risk of death amongst adult patients was 34% (95% CI 28-39, N=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=1169). The risk of death in pediatric patients was 4% (95% CI 1-9, N=102). The RR of death comparing patients with recent systemic anti-cancer therapy to no treatment was 1.17 (95% CI 0.83-1.64; N=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, and pediatric patients appear to be relatively spared. Recent cancer treatment does not appear to significantly increase the risk of death.
Outcomes of Patients With Hematologic Malignancies and COVID-19: A Systematic Review and Meta-Analysis of 3377 Patients
Blood 2020 Oct 28;[EPub Ahead of Print], A Vijenthira, IY Gong, TA Fox, S Booth, G Cook, B Fattizzo, F Martin Moro, J Razanamahery, JC Riches, JI Zwicker, R Patell, MM Vekemans, L Scarfo, T Chatzikonstantinou, H Yildiz, R Lattenist, I Mantzaris, WA Wood, LK Hicks