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The direct and indirect effects of COVID-19 pandemic in a real-life hematological setting #MMPMID33656801
Condom M; Mussetti A; Maluquer C; Parody R; Gonzalez-Barca E; Arnan M; Albasanz-Puig A; Pomares H; Salas MQ; Carro I; Pena M; Clapes V; Baca Cano C; Oliveira Ramos AC; Sanz-Linares G; Moreno-Gonzalez G; Mercadal S; Boque C; Gudiol C; Domingo-Domenech E; Sureda A
Cancer Rep (Hoboken) 2021[Aug]; 4 (4): e1358 PMID33656801show ga
BACKGROUND: Clinical outcomes of novel coronavirus 2019 disease (COVID-19) in onco-hematological patients are unknown. When compared to non-immunocompromised patients, onco-hematological patients seem to have higher mortality rates. AIMS: We describe the characteristics and outcomes of a consecutive cohort of 24 onco-hematological patients with COVID-19 during the first month of the pandemic. We also describe variations in healthcare resource utilization within our hematology department. METHODS AND RESULTS: Data from patients between the first month of the pandemic were retrospectively collected. Clinical and logistic data were also collected and compared with the average values from the prior 3 months of activity. Prevalence of COVID-19 in our hematological population was 0.4%. Baseline characteristics were as follows: male sex: 83%, lymphoid diseases: 46%, median age: 69 (22-82) years. Median follow-up in survivors was 14 (9-28) days and inpatient mortality rate was 46%. Average time to moderate/severe respiratory insufficiency and death were 3 (1-10) and 10 (3-18) days, respectively. Only 1 out of every 12 patients who developed moderate to severe respiratory insufficiency recovered. Upon univariate analysis, the following factors were associated with higher mortality: age >/= 70 years (P = .01) and D-dimer >/=900 mcg/L (P = .04). With respect to indirect effects during the COVID-19 pandemic, and when compared with the prior 3 months of activity, inpatient mortality (excluding patients with COVID-19 included in the study) increased by 56%. This was associated with a more frequent use of vasoactive drugs (+300%) and advanced respiratory support (+133%) in the hematology ward. In the outpatient setting, there was a reduction in initial visits (-55%) and chemotherapy sessions (-19%). A significant increase in phone visits was reported (+581%). CONCLUSION: COVID-19 pandemic is associated with elevated mortality in hematological patients. Negative indirect effects are also evident within this setting.
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Cancer+Rep+(Hoboken) 2021 ; 4 (4): e1358
