Chronic lymphocytic leukemia in combination with COVID-19: clinical features and unfavorable prognosis factors
O. L. Kochneva,
E. A. Baryakh,
E. N. Misyurina,
E. I. Zhelnova,
K. V. Yatskov,
T. S. Chudnova,
Yu. Yu. Polyakov,
A. B. Makeshova,
M. A. Mingalimov,
D. D. Ivanova,
L. T. Shimanovskaya,
E. N. Zotina,
T. N. Tolstykh,
E. Yu. Grishina,
D. E. Gagloeva,
V. N. Yakimets,
A. I. Koneva,
E. A. Karimova https://doi.org/10.17650/1818-8346-2023-18-4(Suppl)-64-73
Abstract
Background. At the end of 2019, a new coronavirus infection caused by the SARS-CoV-2 virus was registered. In March 2020, the first cases of COVID-19 were detected in Moscow. Patients with chronic lymphocytic leukemia, characterized by profound immune dysfunction, have risk factors for severe viral disease.
Aim. To identify risk factors for hospital mortality and severe course of COVID-19, as well as to optimize therapeutic and preventive measures.
Materials and methods. The analysis included 238 patients (142 (59 %) men and 96 (41 %) women) with chronic lymphocytic leukemia and COVID-19 with a median age of 66 (37-90) years, who were hospitalized at City Clinical Hospital No. 52 (Moscow) between April 2020 and April 2023. To compare hospital mortality and severity of COVID-19, patients were divided into 2 groups depending on the hospitalization period: 2020-2021 and 2022-2023, which correlates with the prevalence of some SARS-CoV-2 variants from December 2021 and changes in Moscow epidemiological situation.
Results. Overall hospital mortality rate in 2020-2021 was 25 % (n = 45). Age over 73 years was a significant unfavorable factor in men. Cardiovascular diseases increase the risk of death by 2.3 times. Patients with a Charlson Comorbidity Index of 6 or more have a 2.2 times greater risk of death. A history of 1 or more lines of immunochemotherapy increased the risk of hospital mortality by 1.5 times. Relapse/progression of the disease were factors of unfavorable prognosis for patient survival. Binet stage C also showed a significant unfavorable prognosis. When studying all cases of death (n = 51), complications such as myelotoxic agranulocytosis, secondary bacterial complications and severe interstitial pulmonary damage >75 % were identified.
Conclusion. Coronavirus infection caused by SARS-CoV-2 represents an infectious threat among patients with chronic lymphocytic leukemia and may affect the regimen and tactics of antitumor therapy. The use of a full range of preventive measures, vaccination and pre-exposure prophylaxis in this cohort of patients is of great importance.
About the Authors
O. L. Kochneva
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
Ol'ga L. Kochneva.
3 Pekhotnaya St., Moscow 123182
E. A. Baryakh
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991; Build. 1, 2 / 1 Barrikadnaya St., Moscow 125993; 1 Ostrovityanova St., Moscow 117997
E. N. Misyurina
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
E. I. Zhelnova
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
K. V. Yatskov
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182
T. S. Chudnova
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
Yu. Yu. Polyakov
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
A. B. Makeshova
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
M. A. Mingalimov
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
D. D. Ivanova
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182
L. T. Shimanovskaya
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182
E. N. Zotina
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
T. N. Tolstykh
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
E. Yu. Grishina
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182
D. E. Gagloeva
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
V. N. Yakimets
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182
A. I. Koneva
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182
E. A. Karimova
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182
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For citations:
Kochneva O.L., Baryakh E.A., Misyurina E.N., Zhelnova E.I., Yatskov K.V., Chudnova T.S., Polyakov Yu.Yu., Makeshova A.B., Mingalimov M.A., Ivanova D.D., Shimanovskaya L.T., Zotina E.N., Tolstykh T.N., Grishina E.Yu., Gagloeva D.E., Yakimets V.N., Koneva A.I., Karimova E.A. Chronic lymphocytic leukemia in combination with COVID-19: clinical features and unfavorable prognosis factors. Oncohematology. 2023;18(4):64-73. (In Russ.) https://doi.org/10.17650/1818-8346-2023-18-4(Suppl)-64-73
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