Carrara, ElenaRazzaboni, ElisaAzzini, Anna MariaDe Rui, Maria ElenaPinho Guedes, Mariana NunesGorska, AnnaGiannella, MaddalenaBussini, LindaBartoletti, MicheleArbizzani, FedericaPalacios-Baena, Zaira RCaponcello, GiuliaMaldonado, NataliaRodríguez-Baño, JesúsVisco, CarloKrampera, MauroTacconelli, Evelina2023-05-032023-05-032022-10-20http://hdl.handle.net/10668/22039Main 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.enCOVID-19determinantshematological malignanciesmortalityseverityAdultHumansMaleCOVID-19SARS-CoV-2Retrospective StudiesHypertensionDisease ProgressionNeoplasmsresearch article36238977open access10.1002/hon.30841099-1069PMC9874549https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9874549https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9874549/pdf