RT Journal Article
T1 Predictors of clinical evolution of SARS-CoV-2 infection in hematological patients: A systematic review and meta-analysis.
A1 Carrara, Elena
A1 Razzaboni, Elisa
A1 Azzini, Anna Maria
A1 De Rui, Maria Elena
A1 Pinho Guedes, Mariana Nunes
A1 Gorska, Anna
A1 Giannella, Maddalena
A1 Bussini, Linda
A1 Bartoletti, Michele
A1 Arbizzani, Federica
A1 Palacios-Baena, Zaira R
A1 Caponcello, Giulia
A1 Maldonado, Natalia
A1 Rodríguez-Baño, Jesús
A1 Visco, Carlo
A1 Krampera, Mauro
A1 Tacconelli, Evelina
K1 COVID-19
K1 determinants
K1 hematological malignancies
K1 mortality
K1 severity
AB Main aim of this systematic review is to quantify the risk and identify predictors of clinical evolution of SARS-CoV-2 in hematological patients compared to different control populations. Two independent reviewers screened the literature assessing clinical outcomes of SARS-CoV-2 infection in adult patients with active hematological malignancies published up to June 2021. Primary outcome was COVID-19 related mortality, secondary outcomes were hospital and intensive-care admission, mechanical ventilation (MV), and thromboembolic events. Variables related to study setting, baseline patients' demographic, comorbidities, underlying hematological disease, ongoing chemotherapy, COVID-19 presentation, and treatments were extracted. A total of 67 studies including 10,061 hematological patients and 111,143 controls were included. Most of the studies were retrospective cohorts (51 studies, 76%) and only 19 (13%) provided data for a control group. A significant increased risk of clinical progression in the hematological population compared to the controls was found in terms of COVID-19 related mortality (OR, 2.12; 95% CI, 1.77-2.54), hospitalization (OR, 1.98; 95% CI, 1.15-3.43), intensive-care admission (OR, 1.77; 95% CI, 1.38-2.26), and MV (OR, 2.17; 95% CI, 1.71-2.75). The risk remained significantly higher in the subgroup analysis comparing hematological patients versus solid cancer. Meta-regression analysis of uncontrolled studies showed that older age, male sex, and hypertension were significantly related to worse clinical outcomes of COVID-19 in hematological population. Older age and hypertension were found to be associated also to thromboembolic events. In conclusion, hematological patients have a higher risk of COVID-19 clinical progression compared to both the general population and to patients with solid cancer.
YR 2022
FD 2022-10-20
LK http://hdl.handle.net/10668/22039
UL http://hdl.handle.net/10668/22039
LA en
DS RISalud
RD May 10, 2025