key: cord-0897804-maxlkexe
authors: nan
title: ASH Registry Offers Insights on COVID‐19 in Patients with Hematologic Malignancies
date: 2020-12-28
journal: Oncologist
DOI: 10.1002/onco.13657
sha: 0263adfb62b0deb5baf2ab445902f3dba830e2ff
doc_id: 897804
cord_uid: maxlkexe

For patients with blood cancers, the COVID‐19 mortality rate is approximately 20% overall and 33% for those who require hospitalization, according to new data from the ASH Research Collaborative COVID‐19 Registry for Hematology.

The ASH RC COVID-19 for Hematology registry provides deidentified, open-access, real-time summaries of submitted COVID-19 cases, with the goal of informing risk stratification, resource allocation, and patient care. Hematology/ oncology professionals who are treating patients who have tested positive for COVID-19 are encouraged to submit patient case data to the registry [3] .

ASH also provides guidelines and other resources for managing patients with blood cancers and other hematologic disorders during the COVID-19 pandemic on their COVID-19 Resources page [4] .

The analysis included data from 656 patients submitted from more than 100 centers worldwide, including 396 patients from North America. The majority of patients (77%) were aged 40 years or older and 60% were male. Among those who reported ethnicity, 43% were White/Caucasian, 27% were Asian, 17% were Hispanic/Latino/Latina, and 13% were Black/African American. More than half of patients (57%) had comorbidities, including hypertension (50%) and diabetes (30%).

The most common underlying hematologic malignancy was leukemia (57%), followed by lymphoma (25%) and plasma cell malignancies (18%). Prior to their COVID-19 infection, 80% of patients had a cancer-related life expectancy exceeding 12 months. The most common symptoms attributed to COVID-19 were fever, cough, shortness of breath, and fatigue. Approximately 50% of patients received COVID-19-directed therapy, including azithromycin and/or hydroxychloroquine.

Patients were categorized into 3 groups of COVID-19 severity defined by treatment setting: mild, requiring outpatient care (n = 227); moderate, requiring hospitalization (n = 228); and severe, requiring intensive care unit (ICU) admission (n = 136). Patients with unknown illness severity were excluded from this analysis.

The COVID-19 mortality rate was 20% for all patients, but differed markedly by illness severity ( Table 1 ). The mortality rate was 33% for those who required any hospitalization, including ICU care.

The prevalence of moderate or severe illness increased with increasing age: 47%, 62%, and 70% among patients aged 19-39 years, 40-69 years, and ≥70 years, respectively. The mortality rate for patients with moderate or severe illness also increased with age: 6%, 18%, and 33%, respectively.

Researchers also found a relationship between cancerrelated life expectancy and mortality, with better outcomes in patients who had a better pre-COVID prognosis. Among patients who were expected to live >12 months, 58% developed moderate or severe illness and 13% died. By comparison, among those with a shorter life expectancy, 79% developed moderate or severe illness and 51% died.

In addition, the research team found a link between COVID-19 mortality and the lack of ICU care, with some patients opting for palliative care rather than intensive treatment. Patients who declined ICU care had a mortality rate of 73%. In contrast, the mortality rate was 13% for patients who did not forgo ICU care. According to the investigators, these results suggest that there is no reason to withhold ICU care from patients with favorable cancer-related prognoses.

Overall, these findings highlight the value of the ASH RC COVID-19 for Hematology registry and similar registry efforts in responding to the rapidly evolving clinical landscape associated with COVID-19. 

Outcomes of patients with hematologic malignancies and COVID-19: A report from the ASH Research Collaborative Data Hub

Outcomes of patients with hematologic malignancies and COVID-19 infection: A report from the ASH Research Collaborative Data Hub