Chronic lymphocytic leukemia (CLL) is a disease of the elderly, characterized by immunodeficiency. Hence, patients with CLL might be considered more susceptible to severe complications from COVID-19. We undertook this retrospective international multicenter study to characterize the course of COVID-19 in patients with CLL and identify potential predictors of outcome. Of 190 patients with CLL and confirmed COVID-19 diagnosed between 28/03/2020 and 22/05/2020, 151 (79%) presented with severe COVID-19 (need of oxygen and/or intensive care admission). Severe COVID-19 was associated with more advanced age (≥65 years) (odds ratio 3.72 [95% CI 1.79–7.71]). Only 60 patients (39.7%) with severe COVID-19 were receiving or had recent (≤12 months) treatment for CLL at the time of COVID-19 versus 30/39 (76.9%) patients with mild disease. Hospitalization rate for severe COVID-19 was lower (p < 0.05) for patients on ibrutinib versus those on other regimens or off treatment. Of 151 patients with severe disease, 55 (36.4%) succumbed versus only 1/38 (2.6%) with mild disease; age and comorbidities did not impact on mortality. In CLL, (1) COVID-19 severity increases with age; (2) antileukemic treatment (particularly BTK inhibitors) appears to exert a protective effect; (3) age and comorbidities did not impact on mortality, alluding to a relevant role of CLL and immunodeficiency.

COVID-19 severity and mortality in patients with chronic lymphocytic leukemia: a joint study by ERIC, the European Research Initiative on CLL, and CLL Campus

Vitale C.;Foglietta M.;Coscia M.;
2020-01-01

Abstract

Chronic lymphocytic leukemia (CLL) is a disease of the elderly, characterized by immunodeficiency. Hence, patients with CLL might be considered more susceptible to severe complications from COVID-19. We undertook this retrospective international multicenter study to characterize the course of COVID-19 in patients with CLL and identify potential predictors of outcome. Of 190 patients with CLL and confirmed COVID-19 diagnosed between 28/03/2020 and 22/05/2020, 151 (79%) presented with severe COVID-19 (need of oxygen and/or intensive care admission). Severe COVID-19 was associated with more advanced age (≥65 years) (odds ratio 3.72 [95% CI 1.79–7.71]). Only 60 patients (39.7%) with severe COVID-19 were receiving or had recent (≤12 months) treatment for CLL at the time of COVID-19 versus 30/39 (76.9%) patients with mild disease. Hospitalization rate for severe COVID-19 was lower (p < 0.05) for patients on ibrutinib versus those on other regimens or off treatment. Of 151 patients with severe disease, 55 (36.4%) succumbed versus only 1/38 (2.6%) with mild disease; age and comorbidities did not impact on mortality. In CLL, (1) COVID-19 severity increases with age; (2) antileukemic treatment (particularly BTK inhibitors) appears to exert a protective effect; (3) age and comorbidities did not impact on mortality, alluding to a relevant role of CLL and immunodeficiency.
2020
34
9
2354
2363
Age Factors; Aged; Aged, 80 and over; Antineoplastic Agents; Comorbidity; Coronavirus Infections; Female; Humans; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Middle Aged; Pandemics; Pneumonia, Viral; Prognosis; Protein Kinase Inhibitors; Pyrazoles; Pyrimidines; Retrospective Studies; Severity of Illness Index; Surveys and Questionnaires; Betacoronavirus
Scarfo L.; Chatzikonstantinou T.; Rigolin G.M.; Quaresmini G.; Motta M.; Vitale C.; Garcia-Marco J.A.; Hernandez-Rivas J.A.; Miras F.; Baile M.; Marquet J.; Niemann C.U.; Reda G.; Munir T.; Gimeno E.; Marchetti M.; Quaglia F.M.; Varettoni M.; Delgado J.; Iyengar S.; Janssens A.; Marasca R.; Ferrari A.; Cuellar-Garcia C.; Itchaki G.; Spacek M.; De Paoli L.; Laurenti L.; Levin M.-D.; Lista E.; Mauro F.R.; Simkovic M.; Van Der Spek E.; Vandenberghe E.; Trentin L.; Wasik-Szczepanek E.; Ruchlemer R.; Bron D.; De Paolis M.R.; Del Poeta G.; Farina L.; Foglietta M.; Gentile M.; Herishanu Y.; Herold T.; Jaksic O.; Kater A.P.; Kersting S.; Malerba L.; Orsucci L.; Popov V.M.; Sportoletti P.; Yassin M.; Pocali B.; Barna G.; Chiarenza A.; dos Santos G.; Nikitin E.; Andres M.; Dimou M.; Doubek M.; Enrico A.; Hakobyan Y.; Kalashnikova O.; Ortiz Pareja M.; Papaioannou M.; Rossi D.; Shah N.; Shrestha A.; Stanca O.; Stavroyianni N.; Strugov V.; Tam C.; Zdrenghea M.; Coscia M.; Stamatopoulos K.; Rossi G.; Rambaldi A.; Montserrat E.; Foa R.; Cuneo A.; Ghia P.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/1759554
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