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Abstract：
OBJECTIVE: The characteristics of COVID-19 in haematologic patients compared to non-haematologic patients have seldom been analyzed. Our aim was to analyze whether there are differences in clinical characteristics and outcome of haematologic patients with COVID-19 as compared to non-haematologic.
METHODS: Retrospective cohort study in 2 University hospitals of patients admitted with laboratory-confirmed COVID-19 included in the SEMICOVID19 database. The cohort with underlying haematologic disease was compared to a cohort of age and date-of-COVID-19-matched controls without haematologic disease (1:2).
RESULTS: 71 cases and 142 controls were included from March-May 2020.Twenty (28.1%) had received recent chemotherapy. Twelve (16.9%) were stem cell transplant recipients (SCT). Eleven (15.5%) were neutropenic concurrently with COVID-19 diagnosis.Haematologic patients presented ARDS (58.5 vs 20.7%, p = 0.0001), thrombotic complications (15.7 vs 2.1%, p = 0.002), DIC (5.7 vs 0.0%, p = 0.011), heart failure (14.3 vs 4.9%, p = 0.029) and required ICU admission (15.5 vs 2.8%, p = 0.001), MV (14.1% vs 2.1%, p 0.001), steroid (64.8 vs 33.1%, p = 0.0001), tocilizumab (33.8 vs 8.5%, p = 0.0001) or anakinra treatment (9.9% vs 0%, p = 0.0001) more often. In-hospital mortality was significantly higher (38.0% vs 18.3%, p = 0.002).
CONCLUSIONS: Our results suggest COVID-19 has worse outcomes in haematologic patients than in non-haematologic, independently of age, and that the development of ARDS and thrombotic complications drive the higher in-hospital mortality.
METHODS: Retrospective cohort study in 2 University hospitals of patients admitted with laboratory-confirmed COVID-19 included in the SEMICOVID19 database. The cohort with underlying haematologic disease was compared to a cohort of age and date-of-COVID-19-matched controls without haematologic disease (1:2).
RESULTS: 71 cases and 142 controls were included from March-May 2020.Twenty (28.1%) had received recent chemotherapy. Twelve (16.9%) were stem cell transplant recipients (SCT). Eleven (15.5%) were neutropenic concurrently with COVID-19 diagnosis.Haematologic patients presented ARDS (58.5 vs 20.7%, p = 0.0001), thrombotic complications (15.7 vs 2.1%, p = 0.002), DIC (5.7 vs 0.0%, p = 0.011), heart failure (14.3 vs 4.9%, p = 0.029) and required ICU admission (15.5 vs 2.8%, p = 0.001), MV (14.1% vs 2.1%, p 0.001), steroid (64.8 vs 33.1%, p = 0.0001), tocilizumab (33.8 vs 8.5%, p = 0.0001) or anakinra treatment (9.9% vs 0%, p = 0.0001) more often. In-hospital mortality was significantly higher (38.0% vs 18.3%, p = 0.002).
CONCLUSIONS: Our results suggest COVID-19 has worse outcomes in haematologic patients than in non-haematologic, independently of age, and that the development of ARDS and thrombotic complications drive the higher in-hospital mortality.
摘要：
目的：血液病患者与非血液病患者相比，COVID-19的特征很少被分析。我们的目的是分析COVID-19血液学患者与非血液学患者的临床特征和结局是否存在差异。
方法：在2所大学医院进行回顾性队列研究，纳入SEMICOVID19数据库中的实验室确诊COVID-19患者。将患有基础血液病的队列与年龄和COVID-19日期相匹配的无血液病的对照组进行比较(1：2)。
结果：纳入了2020年3月至5月的71例病例和142例对照。20人（28.1%）最近接受过化疗。12例（16.9%）为干细胞移植受者（SCT）。11例（15.5%）与COVID-19诊断同时出现中性粒细胞减少。血液病患者出现ARDS（58.5vs20.7%，p=0.0001),血栓性并发症（15.7vs2.1％，p=0.002),DIC（5.7vs0.0%，p=0.011),心力衰竭（14.3vs4.9%，p=0.029）和要求入住ICU（15.5vs2.8%，p=0.001),MV（14.1%对2.1%，p0.001)，类固醇（64.8vs33.1%，p=0.0001),托珠单抗（33.8%vs8.5%，p=0.0001)或anakinra治疗(9.9%vs0%，p=0.0001）更频繁。住院死亡率明显更高（38.0%vs18.3%，p=0.002)。
结论：我们的结果表明，与非血液病患者相比，COVID-19在血液病患者中的预后较差，独立于年龄,ARDS和血栓性并发症的发展导致更高的院内死亡率。
方法：在2所大学医院进行回顾性队列研究，纳入SEMICOVID19数据库中的实验室确诊COVID-19患者。将患有基础血液病的队列与年龄和COVID-19日期相匹配的无血液病的对照组进行比较(1：2)。
结果：纳入了2020年3月至5月的71例病例和142例对照。20人（28.1%）最近接受过化疗。12例（16.9%）为干细胞移植受者（SCT）。11例（15.5%）与COVID-19诊断同时出现中性粒细胞减少。血液病患者出现ARDS（58.5vs20.7%，p=0.0001),血栓性并发症（15.7vs2.1％，p=0.002),DIC（5.7vs0.0%，p=0.011),心力衰竭（14.3vs4.9%，p=0.029）和要求入住ICU（15.5vs2.8%，p=0.001),MV（14.1%对2.1%，p0.001)，类固醇（64.8vs33.1%，p=0.0001),托珠单抗（33.8%vs8.5%，p=0.0001)或anakinra治疗(9.9%vs0%，p=0.0001）更频繁。住院死亡率明显更高（38.0%vs18.3%，p=0.002)。
结论：我们的结果表明，与非血液病患者相比，COVID-19在血液病患者中的预后较差，独立于年龄,ARDS和血栓性并发症的发展导致更高的院内死亡率。
