TY - JOUR
T1 - Secondary infections worsen the outcome of COVID-19 in patients with hematological malignancies: A report from the ITA-HEMA-COV
AU - Zappasodi, Patrizia
AU - Cattaneo, Chiara
AU - Valeria Ferretti, Virginia
AU - Mina, Roberto
AU - José María Ferreri, Andrés
AU - Merli, Francesco
AU - Oberti, Margherita
AU - Krampera, Mauro
AU - Romano, Alessandra
AU - Zerbi, Caterina
AU - Ferrari, Jacqueline
AU - Cavo, Michele
AU - Salvini, Marco
AU - Bertù, Lorenza
AU - Stefano Fracchiolla, Nicola
AU - Marchesi, Francesco
AU - Massaia, Massimo
AU - Marasco, Vincenzo
AU - Cairoli, Roberto
AU - Maria Scattolin, Anna
AU - Maria Vannucchi, Alessandro
AU - Gambacorti-Passerini, Carlo
AU - Musto, Pellegrino
AU - Gherlinzoni, Filippo
AU - Cuneo, Antonio
AU - Pinto, Antonello
AU - Trentin, Livio
AU - Bocchia, Monica
AU - Galimberti, Sara
AU - Coviello, Elisa
AU - Chiara Tisi, Maria
AU - Morotti, Alessandro
AU - Falini, Brunangelo
AU - Turrini, Mauro
AU - Tafuri, Agostino
AU - Billio, Atto
AU - Gentile, Massimo
AU - Massimo Lemoli, Roberto
AU - Venditti, Adriano
AU - Giovanni Della Porta, Matteo
AU - Lanza, Francesco
AU - Rigacci, Luigi
AU - Tosi, Patrizia
AU - Mohamed, Sara
AU - Corso, Alessandro
AU - Luppi, Mario
AU - Giuliani, Nicola
AU - Busca, Alessandro
AU - Pagano, Livio
AU - Bruno, Raffaele
AU - Antonio Grossi, Paolo
AU - Corradini, Paolo
AU - Passamonti, Francesco
AU - Arcaini, Luca
PY - 2022
Y1 - 2022
N2 - The impact of secondary infections (SI) on COVID-19 outcome in patients with hematological malignancies (HM) is scarcely documented. To evaluate incidence, clinical characteristics, and outcome of SI, we analyzed the microbiologically documented SI in a large multicenter cohort of adult HM patients with COVID-19. Among 1741 HM patients with COVID-19, 134 (7.7%) had 185 SI, with a 1-month cumulative incidence of 5%. Median time between COVID-19 diagnosis and SI was 16 days (IQR: 5–36). Acute myeloid leukemia (AML) and lymphoma/plasma cell neoplasms (PCN) were more frequent diagnoses in SI patients compared to patients without SI (AML: 14.9% vs. 7.1%; lymphoma/PCN 71.7% vs. 65.3%). Patients with SI were older (median age 70 vs. 66 years, p = 0.002), with more comorbidities (median Charlson Comorbidity Index 5 vs. 4, p < 0.001), higher frequency of critical COVID-19 (19.5% vs. 11.5%, p = 0.046), and more frequently not in complete remission (75% vs. 64.7% p = 0.024). Blood and bronchoalveolar lavage were the main sites of isolation for SI. Etiology of infections was bacterial in 80% (n = 148) of cases, mycotic in 9.7% (n = 18) and viral in 10.3% (n = 19); polymicrobial infections were observed in 24 patients (18%). Escherichia coli represented most of Gram-negative isolates (18.9%), while coagulase-negative Staphylococci were the most frequent among Gram-positive (14.2%). The 30-day mortality of patients with SI was higher when compared to patients without SI (69% vs. 15%, p < 0.001). The occurrence of SI worsened COVID-19 outcome in HM patients. Timely diagnosis and adequate management should be considered to improve their prognosis.
AB - The impact of secondary infections (SI) on COVID-19 outcome in patients with hematological malignancies (HM) is scarcely documented. To evaluate incidence, clinical characteristics, and outcome of SI, we analyzed the microbiologically documented SI in a large multicenter cohort of adult HM patients with COVID-19. Among 1741 HM patients with COVID-19, 134 (7.7%) had 185 SI, with a 1-month cumulative incidence of 5%. Median time between COVID-19 diagnosis and SI was 16 days (IQR: 5–36). Acute myeloid leukemia (AML) and lymphoma/plasma cell neoplasms (PCN) were more frequent diagnoses in SI patients compared to patients without SI (AML: 14.9% vs. 7.1%; lymphoma/PCN 71.7% vs. 65.3%). Patients with SI were older (median age 70 vs. 66 years, p = 0.002), with more comorbidities (median Charlson Comorbidity Index 5 vs. 4, p < 0.001), higher frequency of critical COVID-19 (19.5% vs. 11.5%, p = 0.046), and more frequently not in complete remission (75% vs. 64.7% p = 0.024). Blood and bronchoalveolar lavage were the main sites of isolation for SI. Etiology of infections was bacterial in 80% (n = 148) of cases, mycotic in 9.7% (n = 18) and viral in 10.3% (n = 19); polymicrobial infections were observed in 24 patients (18%). Escherichia coli represented most of Gram-negative isolates (18.9%), while coagulase-negative Staphylococci were the most frequent among Gram-positive (14.2%). The 30-day mortality of patients with SI was higher when compared to patients without SI (69% vs. 15%, p < 0.001). The occurrence of SI worsened COVID-19 outcome in HM patients. Timely diagnosis and adequate management should be considered to improve their prognosis.
KW - COVID-19
KW - secondary infections
KW - outcome
KW - hematological malignancies
KW - COVID-19
KW - secondary infections
KW - outcome
KW - hematological malignancies
UR - http://hdl.handle.net/10807/223853
U2 - 10.1002/hon.3048
DO - 10.1002/hon.3048
M3 - Article
SN - 0278-0232
VL - 40
SP - 846
EP - 856
JO - Hematological Oncology
JF - Hematological Oncology
ER -