Clinical course and risk factors for mortality from COVID‐19 in patients with haematological malignancies

Background The impact of coronavirus disease 2019 (COVID‐19) in haematological patients (HP) has not been comprehensively reported. Methods We analysed 39 patients with SARS‐CoV‐2 infection and haematological malignancies. Clinical characteristics and outcomes were compared to a matched control group of 53 non‐cancer patients with COVID‐19. Univariate and multivariate analyses were carried out to assess the risk factors associated with poor outcome. Results The most frequent haematological diseases were lymphoma (30%) and multiple myeloma (30%). Eighty‐seven % HP developed moderate or severe disease. Patients with haematological malignancies had a significantly higher mortality rate compared to non‐cancer patients (35.9% vs 13.2%; P = .003 (odds ratio 6.652). The worst outcome was observed in chronic lymphocytic leukaemia patients. Only age >70 years and C reactive protein >10 mg/dl at admission were associated with higher risk of death (odds ratio 34.86, P = .003 and 13.56,P = .03). Persistent viral sheddind was detected in 5 HP. Active chemotherapy, viral load at diagnosis and COVID‐19 therapy were not predictors of outcome. Conclusion Mortality of COVID‐19 is significantly higher in patients with haematological malignancies compared to non‐cancer patients. The impact of persistent viral shedding must be considered in order to re‐start therapies and maintain infectious control measures.