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Patients Recently Treated for B-lymphoid Malignancies Show Increased Risk of Severe COVID-19.

ABSTRACT: Patients with B-lymphoid malignancies have been consistently identified as a population at high risk of severe COVID-19. Whether this is exclusively due to cancer-related deficits in humoral and cellular immunity, or whether risk of severe COVID-19 is increased by anticancer therapy, is uncertain. Using data derived from the COVID-19 and Cancer Consortium (CCC19), we show that patients treated for B-lymphoid malignancies have an increased risk of severe COVID-19 compared with control populations of patients with non-B-lymphoid malignancies. Among patients with B-lymphoid malignancies, those who received anticancer therapy within 12 months of COVID-19 diagnosis experienced increased COVID-19 severity compared with patients with non-recently treated B-lymphoid malignancies, after adjustment for cancer status and several other prognostic factors. Our findings suggest that patients recently treated for a B-lymphoid malignancy are at uniquely high risk for severe COVID-19.

Significance

Our study suggests that recent therapy for a B-lymphoid malignancy is an independent risk factor for COVID-19 severity. These findings provide rationale to develop mitigation strategies targeted at the uniquely high-risk population of patients with recently treated B-lymphoid malignancies. This article is highlighted in the In This Issue feature, p. 171.

SUBMITTER: Rubinstein SM

PROVIDER: S-EPMC9355598 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Patients Recently Treated for B-lymphoid Malignancies Show Increased Risk of Severe COVID-19.

Rubinstein Samuel M SM Bhutani Divaya D Lynch Ryan C RC Hsu Chih-Yuan CY Shyr Yu Y Advani Shailesh S Mesa Ruben A RA Mishra Sanjay S Mundt Daniel P DP Shah Dimpy P DP Sica R Alejandro RA Stockerl-Goldstein Keith E KE Stratton Catherine C Weiss Matthias M Beeghly-Fadiel Alicia A Accordino Melissa M Assouline Sarit E SE Awosika Joy J Bakouny Ziad Z Bashir Babar B Berg Stephanie S Bilen Mehmet Asim MA Castellano Cecilia A CA Cogan Jacob C JC Kc Devendra D Friese Christopher R CR Gupta Shilpa S Hausrath Daniel D Hwang Clara C Johnson Nathalie A NA Joshi Monika M Kasi Anup A Klein Elizabeth J EJ Koshkin Vadim S VS Kuderer Nicole M NM Kwon Daniel H DH Labaki Chris C Latif Tahir T Lau Eric E Li Xuanyi X Lyman Gary H GH McKay Rana R RR Nagaraj Gayathri G Nizam Amanda A Nonato Taylor K TK Olszewski Adam J AJ Polimera Hyma V HV Portuguese Andrew J AJ Puc Matthew M MM Razavi Pedram P Rosovski Rachel R Schmidt Andrew A Shah Sumit A SA Shastri Aditi A Su Christopher C Torka Pallawi P Wise-Draper Trisha M TM Zubiri Leyre L Warner Jeremy L JL Thompson Michael A MA

Blood cancer discovery 20220501 3

Patients with B-lymphoid malignancies have been consistently identified as a population at high risk of severe COVID-19. Whether this is exclusively due to cancer-related deficits in humoral and cellular immunity, or whether risk of severe COVID-19 is increased by anticancer therapy, is uncertain. Using data derived from the COVID-19 and Cancer Consortium (CCC19), we show that patients treated for B-lymphoid malignancies have an increased risk of severe COVID-19 compared with control populations ...[more]

PMID: 35262738

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Project description:IntroductionFrailty is a known risk factor for many diseases, including COVID-19. However, many frail patients are undiagnosed as the diagnosis can be cumbersome. Alanine transaminase (ALT) is found not only in the liver but also in the muscle tissue, and multiple studies show that frail sarcopenic patients have lower ALT. Frail patients are at increased risk for severe COVID-19. We evaluated the association between pre-infection low ALT and the risk for severe COVID-19.MethodsWe collected data regarding all subjects tested for SARS-CoV-2 between 1 March 2020 and 31 December 2021 from a national state-mandatory HMO in Israel, serving more than 1.3 million patients. Clinical and laboratory data were collected, including ALT from the year prior to infection. Severe COVID-19 was defined either as death, ICU admission, or ≥10 hospitalization days. Patients with low ALT (ALT ≤ 10 IU/l) were compared with patients with normal ALT (11-40 IU/l). Patients younger than 18 years with a diagnosis of liver disease and with ALT > 40 IU/l were excluded.ResultsDuring the study period, 58,961 patients tested positive for SARS-CoV-2. The patients in the low ALT group were younger (40.53 vs. 42.73, p < 0.001), less likely to be males (12.3 vs. 38.7%, p < 0.001), and had lower BMI (25.97 vs. 27.15, p < 0.001). The patients in the low ALT group had higher mortality (2.36 vs. 0.57%, p < 0.001), more ICU hospitalizations (0.49 vs. 0.41%, p = 0.47), and more prolonged hospitalizations [2.63% (95% CI 2-3.2%) vs. 0.98% (95% CI 0.86-1.1%) p < 0.001]. In multivariate logistic regression analyses, low ALT was associated with an increased risk of severe COVID-19, with increased mortality (OR 1.88, 95% CI 1.37-2.56) and prolonged hospitalization (OR 1.78, 95% CI 1.33-2.35).ConclusionLow ALT level prior to infection is a significant risk factor for morbidity and mortality from COVID-19 infection. Further studies are warranted to address treatment options for this population.

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Patients Recently Treated for B-lymphoid Malignancies Show Increased Risk of Severe COVID-19.

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Patients Recently Treated for B-lymphoid Malignancies Show Increased Risk of Severe COVID-19.

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