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Age, successive waves, immunization, and mortality in elderly COVID-19 hematological patients: EPICOVIDEHA findings
G. Rossi, J. Salmanton-García, C. Cattaneo, F. Marchesi, J. Dávila-Valls, S. Martín-Pérez, F. Itri, A. López-García, A. Glenthøj, M. Gomes da Silva, C. Besson, M. Marchetti, B. Weinbergerová, O. Jaksic, M. Jiménez, YM. Bilgin, J. Van Doesum, F....
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Document type Journal Article
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- MeSH
- COVID-19 * MeSH
- Hematologic Neoplasms * complications MeSH
- Immunization MeSH
- Humans MeSH
- Lymphopenia * MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Vaccination MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
OBJECTIVES: Elderly patients with hematologic malignancies face the highest risk of severe COVID-19 outcomes. The infection's impact on different age groups remains unstudied in detail. METHODS: We analyzed elderly patients (age groups: 65-70, 71-75, 76-80, and >80 years old) with hematologic malignancies included in the EPICOVIDEHA registry between January 2020 and July 2022. Univariable and multivariable Cox regression models were conducted to identify factors influencing death in COVID-19 patients with hematological malignancy. RESULTS: The study included data from 3,603 elderly patients (aged 65 or older) with hematological malignancy, with a majority being male (58.1%) and a significant proportion having comorbidities. The patients were divided into four age groups, and the analysis assessed COVID-19 outcomes, vaccination status, and other variables in relation to age and pandemic waves. The 90-day survival rate for patients with COVID-19 was 71.2%, with significant differences between groups. The pandemic waves had varying impacts, with the first wave affecting patients over 80 years old, the second being more severe in 65-70, and the third being the least severe in all age groups. Factors contributing to 90-day mortality included age, comorbidities, lymphopenia, active malignancy, acute leukemia, less than three vaccine doses, severe COVID-19, and using only corticosteroids as treatment. CONCLUSION: These data underscore the heterogeneity of elderly hematological patients, highlight the different impacts of COVID-19 waves and the pivotal importance of vaccination, and may help in planning future healthcare efforts.
Ankara University Ankara Turkey
ASST Grande Ospedale Metropolitano Niguarda Milan Italy
Azienda Ospedaliera Nazionale SS Antonio e Biagio e Cesare Arrigo Alessandria Italy
Azienda Ospedaliera San Gerardo Monza Monza Italy
Azienda Sanitaria Universitaria del Friuli Centrale Udine Italy
Centre Hospitalier de Versailles Le Chesnay France
Centro Hospitalar e Universitário São João Porto Portugal
CIBERINFEC Instituto de Salud Carlos 3 Madrid Spain
Clinic for Orthopedic Surgery and Traumatology University Clinical Center of Serbia Belgrade Serbia
Clinic of Hematology Clinical Center of Serbia Belgrade Serbia
Complejo Hospitalario de Navarra Iruña Pamplona Spain
COVID hospital Batajnica Belgrade Serbia
Departament de Medicina Universitat Autònoma de Barcelona Bellaterra Spain
Department of Clinical and Biological Sciences University of Turin Turin Italy
Department of Hematology and Oncology Medical University of Innsbruck Innsbruck Austria
Department of Hematology Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
Department of Hematology Hospital Universitario de Burgos Burgos Spain
Department of Hematology Research Unit Hospital Universitario de Burgos Burgos Spain
Department of Hematology University Hospital Dubrava Zagreb Croatia
Department of Infectious Diseases Karolinska University Hospital Stockholm Sweden
Department of Internal Medicine ADRZ Goes Netherlands
Department of Medicine Section of Hematology University of Verona Verona Italy
Department of Medicine University Medical Center Hamburg Eppendorf Hamburg Germany
Department of Nephrology and Infectious diseases AZ Sint Jan Brugge Oostende AV Brugge Belgium
Division of Hematology and Oncology Weill Cornell Medicine New York United States
Dokuz Eylul University Division of Hematology Izmir Turkey
Ematologia con Trapianto Ospedale Dimiccoli Barletta Barletta Italy
Federal University of Rio de Janeiro Rio de Janeiro Brazil
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy
Fundacion Jimenez Diaz University Hospital Health Research Institute IIS FJD Madrid Spain
German Centre for Infection Research Partner Site Bonn Cologne Cologne Germany
Gomel State Medical University Gomel Belarus
Hematology and Stem Cell Transplant Unit IRCCS Regina Elena National Cancer Institute Rome Italy
Hematology and Stem Cell Transplant Unit Vito Fazzi Lecce
Hematology Department Hospital Universitario de Salamanca Salamanca Spain
Hematology Department of Biomedicine and Prevention University of Rome Tor Vergata Rome Italy
Hematology Unit ASST Spedali Civili Brescia Italy
Hematology Unit Center for Translational Medicine Azienda USL Toscana NordOvest Livorno Italy
Hematology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy
Hematology Unit Università Cattolica del Sacro Cuore Rome Italy
Hospital Clinic Barcelona Spain
Hospital Escuela de Agudos Dr Ramón Madariaga Posadas Argentina
Hospital Nuestra Señora de Sonsoles Ávila Spain
Hospital Universitario 12 de Octubre Madrid Spain
Hospital Universitario Marqués de Valdecilla Santander Spain
Hospital Universitario Puerta de Hierro Majadahonda Spain
Hospital University of Parma Hematology and Bone Marrow Unit Parma Italy
IBSAL Centro de Investigación del Cáncer IBMCC Salamanca Spain
Institute of Hematology and Blood Transfusion Prague Czech Republic
IRCCS AOU San Martino Genova Italia
IRCCS Ospedale San Raffaele Milan Italy
King's College Hospital London United Kingdom
King's College London London United Kingdom
La Paz University Hospital Madrid Spain
Medizinische Klinik 2 Klinikum rechts der Isar TU München Munich Germany
NIHR Oxford Biomedical Research Centre Churchill Hospital Oxford United Kingdom
Oncology Center Mansoura University Mansoura Egypt
Portuguese Institute of Oncology Lisbon Portugal
San Luigi Gonzaga Hospital Orbassano Orbassano Italy
Stem Cell Transplant Center AOU Citta' della Salute e della Scienza Turin Italy
Università Milano Bicocca Milan Italy
Université Paris Saclay UVSQ Inserm Équipe Exposome et Hérédité CESP Villejuif France
University Clinical Center Serbia Medical Faculty University Belgrade Belgrade Serbia
University Hospital Centre Rijeka Rijeka Croatia
University Hospital Hradec Králové Hradec Králové Czech Republic
University Hospital Olomouc Olomouc Czech Republic
References provided by Crossref.org
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- $a Age, successive waves, immunization, and mortality in elderly COVID-19 hematological patients: EPICOVIDEHA findings / $c G. Rossi, J. Salmanton-García, C. Cattaneo, F. Marchesi, J. Dávila-Valls, S. Martín-Pérez, F. Itri, A. López-García, A. Glenthøj, M. Gomes da Silva, C. Besson, M. Marchetti, B. Weinbergerová, O. Jaksic, M. Jiménez, YM. Bilgin, J. Van Doesum, F. Farina, P. Žák, L. Verga, GP. Collins, V. Bonuomo, J. Van Praet, M. Nucci, S. Meers, I. Espigado, NS. Fracchiolla, T. Valković, CB. Poulsen, N. Čolović, G. Dragonetti, MP. Ledoux, C. Tascini, C. Buquicchio, O. Blennow, F. Passamonti, M. Machado, J. Labrador, RF. Duarte, M. Schönlein, L. Prezioso, I. Falces-Romero, A. Kulasekararaj, C. Garcia-Vidal, N. Fernández, G. Abu-Zeinah, I. Ormazabal-Vélez, T. Adžić-Vukičević, K. Piukovics, I. Stoma, A. Cuccaro, G. Magliano, T. Szotkowski, TJ. González-López, S. El-Ashwah, R. Bergantim, U. Sili, J. Maertens, F. Demirkan, C. De Ramón, V. Petzer, MI. Del Principe, M. Navrátil, M. Dargenio, GC. Seval, M. Samarkos, Z. Ráčil, LI. Pinczés, T. Lahmer, A. Busca, GA. Méndez, A. Vena, MM. Biernat, M. Merelli, M. Calbacho, A. Barać, M. Bavastro, A. Limongelli, O. Ilhan, D. Wolf, GM. Çolak, R. García-Sanz, Z. Emarah, B. Mišković, SK. Gräfe, M. Mladenović, TF. Aiello, L. Núñez-Martín-Buitrago, A. Nordlander, E. Arellano, GPM. Zambrotta, E. Ammatuna, A. Cabirta, MV. Sacchi, R. Nunes Rodrigues, DS. Hersby, M. Hanakova, L. Rahimli, R. Cordoba, OA. Cornely, L. Pagano, Collaborators
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- $a OBJECTIVES: Elderly patients with hematologic malignancies face the highest risk of severe COVID-19 outcomes. The infection's impact on different age groups remains unstudied in detail. METHODS: We analyzed elderly patients (age groups: 65-70, 71-75, 76-80, and >80 years old) with hematologic malignancies included in the EPICOVIDEHA registry between January 2020 and July 2022. Univariable and multivariable Cox regression models were conducted to identify factors influencing death in COVID-19 patients with hematological malignancy. RESULTS: The study included data from 3,603 elderly patients (aged 65 or older) with hematological malignancy, with a majority being male (58.1%) and a significant proportion having comorbidities. The patients were divided into four age groups, and the analysis assessed COVID-19 outcomes, vaccination status, and other variables in relation to age and pandemic waves. The 90-day survival rate for patients with COVID-19 was 71.2%, with significant differences between groups. The pandemic waves had varying impacts, with the first wave affecting patients over 80 years old, the second being more severe in 65-70, and the third being the least severe in all age groups. Factors contributing to 90-day mortality included age, comorbidities, lymphopenia, active malignancy, acute leukemia, less than three vaccine doses, severe COVID-19, and using only corticosteroids as treatment. CONCLUSION: These data underscore the heterogeneity of elderly hematological patients, highlight the different impacts of COVID-19 waves and the pivotal importance of vaccination, and may help in planning future healthcare efforts.
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