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1.
Cancer Rep (Hoboken) ; 4(4): e1358, 2021 08.
Artículo en Inglés | MEDLINE | ID: mdl-33656801

RESUMEN

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.


Asunto(s)
Antineoplásicos/uso terapéutico , Antivirales/uso terapéutico , COVID-19/complicaciones , Neoplasias Hematológicas/mortalidad , SARS-CoV-2/aislamiento & purificación , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/transmisión , COVID-19/virología , Quimioterapia Combinada , Femenino , Neoplasias Hematológicas/tratamiento farmacológico , Neoplasias Hematológicas/epidemiología , Neoplasias Hematológicas/virología , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , España/epidemiología , Tasa de Supervivencia , Adulto Joven , Tratamiento Farmacológico de COVID-19
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