COVID-19-related mortality in patients with haematological malignancy has decreased significantly over the course of the pandemic. In addition to age, neutropenia also appears to be a risk factor.
Early in the COVID-19 pandemic, patients with cancer, particularly those with hematologic malignancy, were found to have worse outcomes than non-cancer patients when infected. However, little is known about whether mortality in patients with haematological malignancy has changed with the availability of vaccinations and different treatments.
The UK National Health Service (NHS) analyzed overall mortality in patients with haematological malignancy after SARS-CoV-2 infection. Four weeks after the diagnosis of COVID-19 this was 21.6%, eight weeks after the diagnosis 27.7%. Mortality was highest in the first wave, decreased in the second wave and decreased further in the third wave, with death rates 4 weeks after diagnosis of 44, 26 and 8%, respectively. It should be noted that at the beginning of the pandemic, large-scale testing was not yet carried out in Great Britain. The COVID-19 patients registered in the first wave required hospital care and were thus sicker.
The main risk factor for death was patient age. Patients who received chemotherapy did not have a higher mortality rate after eight weeks than patients who did not receive chemotherapy (30 vs. 27%). Neutropenia was found to be a risk factor. In patients with neutropenia at the time of infection, the 8-week mortality rate was 43%, in patients without neutropenia it was 25% (p = 0.04).
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Maddox J, et al. Risk factors and outcomes of patients with haematological malignancy and COVID-19: ongoing reduction in mortality during the 3RD wave of the pandemic. EHA2022 Hybrid Congress, abstract S284.