RESUMO
Patients with cancer are poorly represented in coronavirus disease 2019 (COVID-19) series, and heterogeneous series concerning hematology patients have been published. This study aimed to analyze the impact of COVID-19 in patients with lymphoma. We present a multicenter retrospective study from 19 centers in Madrid, Spain, evaluating risk factors for mortality in adult patients with COVID-19 and lymphoma. About 177 patients (55.9% male) were included with a median follow-up of 27 days and a median age of 70 years. At the time of COVID-19 diagnosis, 49.7% of patients were on active treatment. The overall mortality rate was 34.5%. Age >70 years, confusion, urea concentration, respiratory rate, blood pressure, and age >65 score ≥2, heart disease, and chronic kidney disease were associated with higher mortality risk (P < 0.05). Active disease significantly increased the risk of death (hazard ratio, 2.43; 95% confidence interval, 1.23-4.77; P = 0.01). However, active treatment did not modify mortality risk and no differences were found between the different therapeutic regimens. The persistence of severe acute respiratory syndrome coronavirus 2-positive polymerase chain reaction after week 6 was significantly associated with mortality (54.5% versus 1.4%; P < 0.001). We confirm an increased mortality compared with the general population. In view of our results, any interruption or delay in the start of treatment should be questioned given that active treatment has not been demonstrated to increase mortality risk and that achieving disease remission could lead to better outcomes.
RESUMO
BACKGROUND: The purposes of this study were: to study the presence of human herpesvirus-8 (HHV-8) in different Kaposi's sarcoma (KS) epidemiological groups, multiple myeloma (MM), and immunodeficiency-associated lymphoid proliferations; to investigate the potential sexual transmission of HHV-8 by analyzing its presence in women from the general population, human immunodeficiency virus (HIV) seropositive women, and prostitutes; and to establish a reliable and efficient PCR strategy for the detection of HHV-8. PATIENTS AND METHODS: HHV-8 detection was performed by PCR and positive cases were confirmed by automatic bi-directional sequencing. We selected 25 KS, 70 immunodeficiency associated non-Hodgkin's lymphomas (NHL), 30 HIV-positive Hodgkin's lymphomas (HL), and 2 primary effusion lymphomas (PEL). Bone marrow aspirates were available from 41 MM, 9 monoclonal gammopathies of undetermined significance and 24 patients with other disorders. Bone marrow dendritic cell cultures from 12 MM patients were also performed. Cells from cervical, anal, and oral cavity scrapes were examined for the presence of HHV-8 in 40 control women, 10 HIV-seropositive women, and 20 HIV-seronegative prostitutes. Serologic tests were also performed. RESULTS: HHV-8 was specifically detected in 100% KS and PEL, and in 5.7% immunodeficiency associated NHL. All cases of HIV-HL and MM were HHV-8 negative. Antibodies against HHV-8 were found in 10% of control women, 10% HIV-positive women, and 25% prostitutes. Only 1 sample was positive for HHV-8 by PCR. CONCLUSIONS: HHV-8 is associated with all epidemiological forms of KS; HHV-8 does not contribute to the pathogenesis of MM, and this virus is not ubiquitous in the human population. Seroprevalence of HHV-8 is increased in prostitutes, although this may partially be attributed to the geographical origin. For a reliable PCR detection of HHV-8, it is necessary to target different regions of the viral genome and to sequence amplification products.