Open AccessThe direct and indirect effects of COVID‐19 pandemic in a real‐life hematological setting
Author(s) -
Condom Maria,
Mussetti Alberto,
Maluquer Clara,
Parody Rocío,
GonzálezBarca Eva,
Arnan Montserrat,
AlbasanzPuig Adaia,
Pomares Helena,
Salas Maria Queralt,
Carro Itziar,
Peña Marta,
Clapes Victòria,
Baca Cano Cristina,
Oliveira Ramos Ana Carla,
SanzLinares Gabriela,
MorenoGonzález Gabriel,
Mercadal Santiago,
Boqué Concepcion,
Gudiol Carlota,
DomingoDomènech Eva,
Sureda Anna
Publication year - 2021
Publication title -
cancer reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.261
H-Index - 5
ISSN - 2573-8348
DOI - 10.1002/cnr2.1358
Subject(s) - medicine , pandemic , univariate analysis , covid-19 , population , cohort , cohort study , mortality rate , logistic regression , pediatrics , disease , multivariate analysis , infectious disease (medical specialty) , environmental health
Background Clinical outcomes of novel coronavirus 2019 disease (COVID‐19) in onco‐hematological patients are unknown. When compared to non‐immunocompromised patients, onco‐hematological patients seem to have higher mortality rates. Aims We describe the characteristics and outcomes of a consecutive cohort of 24 onco‐hematological patients with COVID‐19 during the first month of the pandemic. We also describe variations in healthcare resource utilization within our hematology department. Methods and Results Data from patients between the first month of the pandemic were retrospectively collected. Clinical and logistic data were also collected and compared with the average values from the prior 3 months of activity. Prevalence of COVID‐19 in our hematological population was 0.4%. Baseline characteristics were as follows: male sex: 83%, lymphoid diseases: 46%, median age: 69 (22‐82) years. Median follow‐up in survivors was 14 (9‐28) days and inpatient mortality rate was 46%. Average time to moderate/severe respiratory insufficiency and death were 3 (1‐10) and 10 (3‐18) days, respectively. Only 1 out of every 12 patients who developed moderate to severe respiratory insufficiency recovered. Upon univariate analysis, the following factors were associated with higher mortality: age ≥ 70 years ( P = .01) and D‐dimer ≥900 mcg/L ( P = .04). With respect to indirect effects during the COVID‐19 pandemic, and when compared with the prior 3 months of activity, inpatient mortality (excluding patients with COVID‐19 included in the study) increased by 56%. This was associated with a more frequent use of vasoactive drugs (+300%) and advanced respiratory support (+133%) in the hematology ward. In the outpatient setting, there was a reduction in initial visits (−55%) and chemotherapy sessions (−19%). A significant increase in phone visits was reported (+581%). Conclusion COVID‐19 pandemic is associated with elevated mortality in hematological patients. Negative indirect effects are also evident within this setting.