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Clinical outcomes and risk factors for severe COVID‐19 infection in patients with haematological disorders receiving chemo‐ or immunotherapy

Fox, TA; Troy-Barnes, E; Kirkwood, AA; Chan, WY; Day, J; Chavda, SJ; Kumar, EA; ... Ardeshna, KM; + view all (2020) Clinical outcomes and risk factors for severe COVID‐19 infection in patients with haematological disorders receiving chemo‐ or immunotherapy. British Journal of Haematology , 191 (2) pp. 194-206. 10.1111/bjh.17027. Green open access

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Abstract

Haematology patients receiving chemo- or immunotherapy are considered to be at greater risk of COVID-19-related morbidity and mortality. We aimed to identify risk factors for COVID-19 severity and assess outcomes in patients where COVID-19 complicated the treatment of their haematological disorder. A retrospective cohort study was conducted in 55 patients with haematological disorders and COVID-19, including 52 with malignancy, 2 with bone marrow failure and 1 immune mediated thrombotic thrombocytopenic purpura (TTP). COVID-19 diagnosis coincided with a new diagnosis of a haematological malignancy in four patients. 82% of patients were on systemic anti-cancer therapy (SACT) at time of COVID-19. Of hospitalised patients, 37% (19/51) died whilst all four outpatients recovered. Risk factors for severe disease or mortality were similar to other published cohorts. Raised CRP at diagnosis predicted an aggressive clinical course. The majority of patients recovered from COVID-19, despite receiving recent SACT. This suggests that SACT, where urgent, should be administered despite intercurrent CV19 infection, which should be managed according to standard pathway. Delay or modification of therapy should be considered on an individual basis. Long-term follow-up studies in larger patient cohorts are required to assess efficacy of treatment strategies employed during the pandemic.

Type: Article
Title: Clinical outcomes and risk factors for severe COVID‐19 infection in patients with haematological disorders receiving chemo‐ or immunotherapy
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/bjh.17027
Publisher version: https://doi.org/10.1002/1873-3468.13125
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > CRUK Cancer Trials Centre
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Haematology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Experimental and Translational Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10106127
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