The evolving landscape of COVID-19 and post-COVID condition in patients with chronic lymphocytic leukemia: A study by ERIC, the European research initiative on CLL.

Hematology and Clinical Immunology Unit, Department of Medicine, University of Padova, Padova, Italy. Institute of Applied Biosciences, Centre for Research and Technology Hellas, Thessaloniki, Greece. Università Vita-Salute San Raffaele and IRCC Ospedale San Raffaele, Milan, Italy. Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece. Department of Mathematics, University of Ioannina, Ioannina, Greece. Centre for Biomedicine, Hull York Medical School, Hull, UK. Spanish Society of Hematology and Hemotherapy (SEHH: Sociedad Española de Hematología y hemoterapia), Madrid, Spain. Hematology Department, Hospital Universitario de La Princesa, Madrid, Spain. Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. University Clinical Center of Serbia, Belgrade, Serbia. School of Medicine, University of Belgrade, Belgrade, Serbia. Hospital Clinico Universitario de Salamanca (CAUSA/IBSAL), Salamanca, Spain. Department of Immunology, Genetics and Pathology, Science for Life Laboratory, Uppsala University, Uppsala, Sweden. Department of Clinical Genetics, Uppsala University Hospital, Uppsala, Sweden. Inst J Bordet (ULB), Brussels, Belgium. Hematology Unit, 1st Dept of Internal Medicine, AUTH, AHEPA Hospital, Thessaloniki, Greece. Department of Hematology, Health Research Institute IIS-FJD, Fundacion Jimenez Diaz University Hospital, Madrid, Spain. Hospital Clínic of Barcelona, Barcelona, Spain. Hematology Unit, Terrassa Hospital, Spain. Division of Hematology, Department of Translational Medicine, Università del Piemonte Orientale Amedeo Avogadro, Azienda Ospedaliero-Universitaria Maggiore della Carità Novara, Novara, Italy. UOC Ematologia PO Vito Fazzi Lecce, Lecce, Italy. 1st Internal Medicine Department, Propaedeutic, Hematology Clinical Trial Unit, National and Kapodistrian University of Athens, Athens, Greece. Belfast City Hospital, Belfast, Northern Ireland. Department of Internal Medicine-Hematology and Oncology, University Hospital, Brno, Czech Republic. Faculty of Medicine, Department of Medical Genetics and Genomics, Masaryk University, Brno, Czech Republic. Department of Haematology, Athens Medical Center-Psychikon Branch, Athens, Greece. Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Cologne, University of Cologne, Cologne, Germany. Medical Oncology Unit, Faculty of Medicine, Oncology Center Mansoura University (OCMU), Mansoura, Egypt. Hospital Italiano La Plata, Buenos Aires, Argentina. Pathology Service, Hospital del Mar, Barcelona, Spain. Hematology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. Hematology Unit, Azienda Unità Sanitaria Locale-IRCCS, Reggio Emilia, Italy. Division of Hematology, AO S. Croce e Carle, Cuneo, Italy. Department of Hematology, Odense University Hospital, Odense, Denmark. Hematology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain. Department of Hematology, Hospital General Universitario, Valencia, Spain. Fundaci_on de Investigaci_on del Hospital General Universitario, Valencia, Spain. Hematology Unit, Azienda Ospedaliera Annunziata, Cosenza, Italy. Department of Pharmacy, Health and Nutritional Science, University of Calabria, Rende, Italy. Department of Hematology, Hospital del Mar, Barcelona, Spain. Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. Hematology Department, Portuguese Institute of Oncology, Lisbon, Portugal. Hematology Center after Prof. Yeolyan MH RA, Yerevan, Armenia. Department of Hematology, Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Hematology Department, Infanta Leonor University Hospital, Madrid, Spain. Department of Medicine III, Laboratory for Leukemia Diagnostics, University Hospital, Munich, Germany. Hematology Unit, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy. Meir Medical Center, Kfar-Saba, Israel. The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Department of Hematology, University Hospital Dubrava, Zagreb, Croatia. Department of Hematology, Universitaire Ziekenhuizen Leuven, Leuven, Belgium. Federal State Budgetary Educational Institution of Higher Education Academician I.P. Pavlov First St. Petersburg State Medical University of the Ministry of Healthcare of Russian Federation, St. Petersburg, Russia. Department and Clinic of Hematology, Blood Neoplasms and Bone Marrow Transplantation Wroclaw Medical University, Wroclaw, Poland. Department of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands. Department of Hematology, Haga Teaching Hospital, The Hague, The Netherlands. Hematology Department, Unit Research, Complejo Asistencial Universitario de Burgos, Burgos, Spain. Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, the Netherlands. Department of Hematology, Santa Chiara Hospital, Trento, Italy. Hematology and Stem Cell Transplant Center, Marche Nord Hospital, Pesaro, Italy. Department of Medical Sciences, Section of Hematology, University of Modena and Reggio E., Modena, Italy. Hematology Unit and BM Transplant Center, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. Hematology Department, Ram_on y Cajal University Hospital, Madrid, Spain. Department of Hematology, Uppsala University Hospital, Uppsala, Sweden. Hematology Unit, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy. Experimental Hematooncology Department, Medical University of Lublin, Lublin, Poland. Hematology Department, St. John's Cancer Center, Lublin, Poland. S.C. Ematologia, ASST Spedali Civili Brescia, Brescia, Italy. Consultant Haematologist, St James's Hospital, Leeds, UK. Hematology and Stem Cell Transplantation Unit, Ospedale Oncologico A. Businco, ARNAS "G. Brotzu", Cagliari, Italy. Hematology Clinic, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy. S.C. Ematologia, Città della Salute e della Scienza di Torino, Turin, Italy. Fundaleu, Clinical Research Center Buenos Aires, Buenos Aires, Argentina. Consultative Hematology Department with a Day Hospital for Intensive High-Dose Chemotherapy, National Research Center for Hematology, Moscow, Russia. HematologyDepartment, Colentina Clinical Hospital, Bucharest, Romania. Hematology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy. Department of Oncology and Hematology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII Bergamo, Bergamo, Italy. Hematologic Section, Department of Internal Medicine, Hospital Union West, Herning, Denmark. St. Anna University Hospital, Ferrara, Italy. Department of Hematology, Shaare-Zedek Medical Center, Affiliated with the Hebrew University Medical School, Jerusalem, Israel. Faculty of Medicine in Hradec Králové, 4th Department of Internal Medicine-Haematology, University Hospital and Charles University in Prague, Hradec Kralove, Czech Republic. First Faculty of Medicine, 1st Department of Medicine-Hematology, Charles University and General Hospital in Prague, Prague, Czech Republic. Department of Medicine and Surgery, Institute of Hematology and Center for Hemato-Oncological Research, University of Perugia, Perugia, Italy. Hematology Department, Coltea Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania. Division of Hematology, Bnai-Zion Medical Center, Haifa, Israel. IRCSS Ospedale San Raffaele, Milan, Italy. Department of Biomedicine and Prevention Hematology, University Tor Vergata, Rome, Italy. Department of Hematology, Shamir Medical Center, Zerifin, Israel. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Faculty of Medicine, Clinical Centre of Vojvodina, University of Novi Sad, Novi Sad, Serbia. Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain. Hematology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan, Milan, Italy. Hematology Unit, Nepal Cancer Hospital & Research Centre, Lalitpur, Nepal. Department of Hematology, Gelderse Vallei Ede, Ede, the Netherlands. Department of Hematology, Lymmcare, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands. Department of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands. Department of Internal Medicine, Maastricht University Medical Center, Maastricht, the Netherlands. Zuyderland Medical Center, Sittard, the Netherlands. Department of Hematooncology and Bone Marrow Transplantation, Medical University in Lublin, Lublin, Poland. Hematology Department, University Hospital and Research Institute of Marqués de Valdecilla (IDIVAL), Santander, Spain. Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Doha, Qatar. Hematology Unit, Cardarelli Hospital, Naples, Italy. St. James Hospital, Trinity College Dublin, Dublin, Ireland. Haemato-oncology Unit, The Royal Marsden Hospital, UK. Division of Hematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Division of Hematology, Department of Molecular Biotechnology and Health Sciences, A.O.U. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy.

American journal of hematology. 2023;(12):1856-1868

Abstract

In this retrospective international multicenter study, we describe the clinical characteristics and outcomes of patients with chronic lymphocytic leukemia (CLL) and related disorders (small lymphocytic lymphoma and high-count monoclonal B lymphocytosis) infected by SARS-CoV-2, including the development of post-COVID condition. Data from 1540 patients with CLL infected by SARS-CoV-2 from January 2020 to May 2022 were included in the analysis and assigned to four phases based on cases disposition and SARS-CoV-2 variants emergence. Post-COVID condition was defined according to the WHO criteria. Patients infected during the most recent phases of the pandemic, though carrying a higher comorbidity burden, were less often hospitalized, rarely needed intensive care unit admission, or died compared to patients infected during the initial phases. The 4-month overall survival (OS) improved through the phases, from 68% to 83%, p = .0015. Age, comorbidity, CLL-directed treatment, but not vaccination status, emerged as risk factors for mortality. Among survivors, 6.65% patients had a reinfection, usually milder than the initial one, and 16.5% developed post-COVID condition. The latter was characterized by fatigue, dyspnea, lasting cough, and impaired concentration. Infection severity was the only risk factor for developing post-COVID. The median time to resolution of the post-COVID condition was 4.7 months. OS in patients with CLL improved during the different phases of the pandemic, likely due to the improvement of prophylactic and therapeutic measures against SARS-CoV-2 as well as the emergence of milder variants. However, mortality remained relevant and a significant number of patients developed post-COVID conditions, warranting further investigations.

Methodological quality

Publication Type : Multicenter Study

Metadata