Outcomes of patients with hematologic malignancies and COVID-19: a systematic review and meta-analysis of 3377 patients

Abi Vijenthira, Inna Y. Gong, Thomas A. Fox, Stephen Booth, Gordon Cook, Bruno Fattizzo, Fernando Martín-Moro, Jerome Razanamahery, John C. Riches, Jeff Zwicker, Rushad Patell, Marie Christiane Vekemans, Lydia Scarfò, Thomas Chatzikonstantinou, Halil Yildiz, Raphaël Lattenist, Ioannis Mantzaris, William A. Wood, Lisa K. Hicks

Research output: Contribution to journalReview articlepeer-review

98 Scopus citations

Abstract

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 20 August 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 intensive care unit admission and ventilation in hospitalized patients. Subgroup analyses included mortality stratified by age, treatment status, and malignancy subtype. Pooled prevalence, risk ratios (RRs), and 95% confidence intervals (CIs) were calculated using a random-effects model. Thirty-four adult and 5 pediatric studies (3377 patients) from Asia, Europe, and North America were included (14 of 34 adult studies included only hospitalized patients). Risk of death among adult patients was 34% (95% CI, 28-39; N 5 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 5 1169). The risk of death in pediatric patients was 4% (95% CI, 1-9; N 5 102). RR of death comparing patients with recent systemic anticancer therapy to no treatment was 1.17 (95% CI, 0.83-1.64; N 5 736). Adult patients with hematologic malignancy and COVID-19, especially hospitalized patients, have a high risk of dying. Patients ‡60 years have significantly higher mortality; pediatric patients appear to be relatively spared. Recent cancer treatment does not appear to significantly increase the risk of death.

Original languageEnglish (US)
Pages (from-to)2881-2892
Number of pages12
JournalBlood
Volume136
Issue number25
DOIs
StatePublished - Dec 17 2020
Externally publishedYes

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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