Characteristic Features of the Novel Coronavirus Infection COVID-19 in Oncohematological Patients

AUTOIMMUNE THROMBOCYTOPENIA

NA Romanenko, ER Shilova, LV Stelmashenko, EI Kaitandzhan, AV Kuleshova, NP Stizhak, VN Chebotkevich, SV Sidorkevich, SV Gritsaev, SS Bessmeltsev

Russian Research Institute of Hematology and Transfusiology, 16 2-ya Sovetskaya ul., Saint Petersburg, Russian Federation, 191024

For correspondence: Nikolai Aleksandrovich Romanenko, MD, PhD, 16 2-ya Sovetskaya ul., Saint Petersburg, Russian Federation, 191024; Tel.: +7(812)717-58-57; e-mail: rom-nik@yandex.ru

For citation: Romanenko NA, Shilova ER, Stelmashenko LV, et al. Characteristic Features of the Novel Coronavirus Infection COVID-19 in Oncohematological Patients. Clinical oncohematology. 2023;16(1):101–8. (In Russ).

DOI: 10.21320/2500-2139-2023-16-1-101-108

ABSTRACT

Background. The novel coronavirus infection SARS-CoV-2 (COVID-19) is one of high-threat respiratory diseases, characterized by multiple organ disorders with primary respiratory failure and population mortality of 2–5 %. However, the mortality of oncohematological patients treated with chemotherapy is considerably higher.

Aim. To analyze the COVID-19 treatment outcomes in hematological malignancy patients who received drug chemotherapy.

Materials & Methods. The clinical course of COVID-19 was analyzed in 32 hematological malignancy patients aged 31–81 years (median 62 years). The disease onset was the date of the first positive COVID-19 PCR test. These patients were transferred to an infectious hospital specialized in the therapy of the novel coronavirus infection. Pneumonia was confirmed by standard radiography and CT. Blood oxygen saturation, body temperature, ECG, and respiratory rate were monitored. Moderate and severe COVID-19 was observed in 17 (53.1 %) of 32 patients. The condition of 15 (46.9 %) patients was described as good. For comparison, a control group was collected from 32- to 79-year-old (median 63 years) patients (n = 28) having hematological malignancies but no COVID-19.

Results. Nine (28.1 %) of 32 patients under analysis died upon increasing respiratory and multiple organ insufficiency on Day 3–17 (mean 8,6 ± 4,6 days) from the first positive COVID-19 PCR test. Death was predominantly reported in multiple myeloma patients (n = 5) as well as in a patient with Waldenstrom’s macroglobulinemia. In the control group (n = 28) with similar hematological tumors but without COVID-19, three (10.7 %) patients died throughout the 12-month follow-up period. The present paper contains a case report illustrating the clinical features of coronavirus infection in a patient with Waldenstrom’s macroglobulinemia, a monoclonal gammopathy with primary bone marrow lesions.

Conclusion. COVID-19 is a life-threatening viral disease with high mortality in patients with hematological malignancies, especially those with plasma cell dyscrasias.

Keywords: novel coronavirus infection, multiple myeloma, pneumonia, thrombosis, blood oxygen saturation, Waldenstrom’s macroglobulinemia.

Received: July 6, 2022

Accepted: December 3, 2022

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Статистика Plumx английский

REFERENCES

  1. Временные методические рекомендации. Профилактика, диагностика и лечение новой коронавирусной инфекции COVID-19. Версия 15 (22.02.2022), 245 с. [электронный документ]. Доступно по: www.ВМР_COVID-19_V15.pdf. Ссылка активна на 23.05.2022.
    [Interim methodological guidelines. Prophylaxis, diagnosis, and treatment of new coronavirus infection COVID-19. Version 15 (22.02.2022), 245 p. (Internet) Available from: www.ВМР_COVID-19_V15.pdf. Accessed 23.05.2022. (In Russ)]
  2. Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199–207. doi: 10.1056/NEJMoa2001316.
  3. Баклаушев В.П., Кулемзин С.В., Горчаков А.А. и др. COVID-19. Этиология, патогенез, диагностика и лечение. Клиническая практика. 2020;11(1):7–20. doi: 10.17816/clinpract
    [Baklaushev VP, Kulemzin SV, Gorchakov АА, et al. COVID-19. Etiology, Pathogenesis, Diagnosis and Treatment. Journal of clinical practice. 2020;11(1):7–20. doi: 10.17816/clinpract26339. (In Russ)]
  4. Болевич C.Б., Болевич С.С. Комплексный механизм развития СOVID-19. Сеченовский вестник. 2020;11(2):50–61. doi: 10.47093/2218-7332.2020.11.2.50-61.
    [Bolevich SB, Bolevich SS. Complex mechanism of COVID-19 development. Sechenov medical journal. 2020;11(2):50–61. doi: 10.47093/2218-7332.2020.11.2.50-61. (In Russ)]
  5. Поддубная И.В., Тумян Г.С., Трофимова О.П. и др. Особенности ведения онкогематологических пациентов в условиях пандемии СОVID-19. Современная онкология. 2020;22(3):45–58. doi: 10.26442/18151434.2020.3.200152.
    [Poddubnaya IV, Tumian GS, Trofimova OP, et al. Features of management of oncohematological patients in the context of the COVID-19 pandemic. Journal of modern oncology. 2020;22(3):45–58. doi: 10.26442/18151434.2020.3.200152. (In Russ)]
  6. Кулешова А.В., Искова И.И., Киселева Е.Е., Чеботкевич В.Н. Респираторные вирусные инфекции, в т. ч. вызванные коронавирусами, у онкологических и онкогематологических больных. Медицинский академический журнал. 2021;21(3):117–20. doi: 10.17816/MAJ
    [Kuleshova AV, Iskova II, Kiseleva EE, Chebotkevich VN. Respiratory viral infections including caused by coronaviruses, in oncological and oncohematological patients. Medical academic journal. 2021;21(3):117–20. doi: 10.17816/MAJ78565. (In Russ)]
  7. Mato A, Roeker L, Lamanna N, et al. Outcomes of COVID-19 in patients with CLL: a multicenter international experience. Blood. 2020;136(10):1134–43. doi: 10.1182/blood.2020006965.
  8. The Lancet Oncology. COVID-19 and cancer: 1 year on. Lancet Oncol. 2021;22(4):411. doi: 10.1016/S1470-2045(21)00148-0.
  9. Временные методические рекомендации. Профилактика, диагностика и лечение новой коронавирусной инфекции COVID-19. Версия 3 (03.03.2020), 62 с. [электронный документ]. Доступно по: www.ВМР_COVID-19_V3.pdf. Ссылка активна на 07.06.2022.
    [Interim methodological guidelines. Prophylaxis, diagnosis, and treatment of new coronavirus infection COVID-19. Version 3 (03.03.2020), 62 p. (Internet) Available from: www.ВМР_COVID-19_V3.pdf. Accessed 07.06.22. (In Russ)]
  10. Романенко Н.А., Бессмельцев С.С., Чечеткин А.В. Коррекция иммунного статуса пациентов иммуноглобулином человека для внутривенного введения. Казанский медицинский журнал. 2017;98(5):775–83. doi: 10.17750/KMJ2017-775.
    [Romanenko NA, Bessmeltsev SS, Chechetkin AV. Correction of patients’ immune status with human intravenous immunoglobulin. Kazan medical journal. 2017;98(5):775–83. doi: 10.17750/KMJ2017-775. (In Russ)]
  11. Mouthon L, Fermand JP, GottenbergE. Management of secondary immune deficiencies: what is the role of immunoglobulins? Curr Opin Allergy Clin Immunol. 2013;13(Suppl 2):S56–S67. doi: 10.1097/01.all.0000433132.16436.b5.
  12. Pratt G, Goodyear O, Moss P. Immunodeficiency and immunotherapy in multiple myeloma. Br J Haematol. 2007;138(5):563–79. doi: 10.1111/j.1365-2141.2007.06705.x.
  13. Бессмельцев С.С., Абдулкадыров К.М. Множественная миелома: руководство для врачей. М.: СИМК, 2016. 512 с.
    [Bessmeltsev SS, Abdulkadyrov KM. Mnozhestvennaya mieloma: rukovodstvo dlya vrachei. (Multiple myeloma: manual for physicians.) Moscow: SIMK Publ.; 2016. 512 p. (In Russ)]