Maintenance oncohematological patients and new coronavirus infection: experience of the City Clinical Hospital №52

Justification. Oncological diseases, along with diabetes, hypertension, cardiovascular and chronic obstructive pulmonary diseases, are associated with severe course and worst prognosis of the new coronavirus infection – COVID-19. Due to the limited number of the international studies and the lack of the domestic publications on the analysis of the course of COVID-19 in patients with oncohematological pathology and the patient management tactics, this work seems extremely topical.

Materials and methods. 24.04.2020–31.05.2020, 110 patients with oncohematological pathology associated with new coronavirus infection were observed on the basis of the hematology service of City Clinical Hospital №52: 59 women and 51 men, mean age 58 (18–90) years.

Results. Currently, 24 (22%) patients among 110 are continuing treatment. The outcome of the disease is observed in 86 (78%) patients: 50 (58%) patients were discharged from hospital with complete or partial resolution of pneumonia, 36 (42%) of the 86 patients died. The groups did not differ in gender. The median age was higher in the group of deceased patients (66 vs. 54 years in patients who had a favorable outcome after COVID-19). The somatic status ECOG 3–4 was an independent predictive factor determining the adverse outcome of the disease. The third part of the patients from the group with a fatal cases due to a severe condition in the debut of the disease immediately were hospitalized in the intensive care unit (ICU), 2 (6%) of them had died within the first day. Disposition, according to the nosology showed a significant predominance among patients with an adverse outcome associated with acute leukemia (18% vs 39%). Patients with resistant course of hemoblastosis accounted for 50% of deceased patients. Severe form of the course of COVID-19 infection was twice as frequently (46% vs 84%) among patients with an adverse outcome of the disease, that was associated with both the initial more severe group of patients (33% were hospitalized in the ICU), and less curability of pneumonia against the background of the adverse prognostic factors: the older age group, the predominance of patients with acute leukemia and resistant course of oncohematological diseases. Specific anticancer therapy and COVID-19 therapy were comparable in both groups.

Conclusions. Identification of new coronavirus infection against a backdrop of oncohematological disease is associated with a severe course of COVID-19 and high death rate – 42%. According to the preliminary obtained results, the adverse prognostic factors of COVID-19 in patients with oncohematological diseases include: elderly age, the poor somatic status (ECOG 3–4), relapse or progression of hemoblastosis and nosological affiliation to acute leukemia.