OncohematologyOncohematologyОнкогематология1818-83462413-4023Publishing House ABV Press89110.17650/1818-8346-2023-18-4(Suppl)-45-52ArticlesСтатьиCOVID-19 in patients with acute leukemia: 3 years' experience of pandemicCOVID-19 у пациентов с острыми лейкозами: опыт 3 лет пандемииhttps://orcid.org/0000-0002-8012-1640ChudnovaT. S.ЧудноваТ. С.
Russian Federation

Tatiana S. Chudnova.

3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991

Чуднова Татьяна Сергеевна.

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chudnova.t.s@gmail.comhttps://orcid.org/0000-0003-2419-4850MisyurinaE. N.МисюринаЕ. Н.
Russian Federation

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https://orcid.org/0000-0001-6880-9269BaryakhE. A.БаряхЕ. А.
Russian Federation

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https://orcid.org/0000-0001-7308-0927TolstykhT. N.ТолстыхТ. Н.
Russian Federation

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https://orcid.org/0000-0002-9401-7991ShimanovskayaL. T.ШимановскаяЛ. Т.
Russian Federation

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https://orcid.org/0000-0001-6254-5362GagloevaD. E.ГаглоеваД. Э.
Russian Federation

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https://orcid.org/0000-0002-0343-9348ZhelnovaE. I.ЖелноваЕ. И.
Russian Federation

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https://orcid.org/0000-0002-0414-2554MakeshovaA. B.МакешоваА. Б.
Russian Federation

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https://orcid.org/0000-0003-0125-9068YatskovK. V.ЯцковК. В.
Russian Federation

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https://orcid.org/0000-0001-9692-2541ZotinaE. N.ЗотинаЕ. Н.
Russian Federation

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https://orcid.org/0009-0004-3632-9198IvanovaD. D.ИвановаД. Д.
Russian Federation

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https://orcid.org/0000-0002-8491-2140MingalimovM. A.МингалимовМ. А.
Russian Federation

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https://orcid.org/0000-0003-1338-8203KochnevaO. L.КочневаО. Л.
Russian Federation

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https://orcid.org/0000-0002-9104-1216GrishinaE. Yu.ГришинаЕ. Ю.
Russian Federation

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https://orcid.org/0009-0007-8389-6269PolyakovYu. Yu.ПоляковЮ. Ю.
Russian Federation

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https://orcid.org/0009-0006-4736-0187YakimetsV. N.ЯкимецВ. Н.
Russian Federation

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City Clinical Hospital No. 52, Moscow Healthcare DepartmentГБУЗ г. Москвы «Городская клиническая больница № 52 Департамента здравоохранения г. Москвы»I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)ФГАОУ ВО Первый Московский государственный медицинский университет им. И.М. Сеченова Минздрава России (Сеченовский Университет)Russian Medical Academy of Continuing Professional Education, Ministry of Health of RussiaФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииN.I. Pirogov Russian National Research Medical University, Ministry of Health of RussiaФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России15012024184SupplementПриложение45521907202315012024https://oncohematology.abvpress.ru/ongm/article/view/891

Patients with acute leukemia are one of the most vulnerable risk groups for infection with SARS-CoV-2 and severe course of coronavirus infection. During the first 2 years of the pandemic, the mortality rate of patients with acute leukemia was 11-48 %, depending on leukemia type, and only reached population levels in 2022. Risk factors for severe COVID-19 in patients with acute leukemia are old age, concomitant cardiac pathology, metabolic syndrome, and the absence of acute leukemia remission. Chemotherapy administered one month before hospitalization with COVID-19 diagnosis showed statistical significance in influencing hospital mortality only in the group of patients with acute myeloid leukemia. Despite this, the international medical community has recommended delaying the start of chemotherapy until clinical symptoms of coronavirus infection have completely resolved and a negative test result for SARS-CoV-2 has been obtained for all types of leukemia. Currently, the most optimal tactic is to prevent SARS-CoV-2 infection by vaccinating patients with acute leukemia receiving antitumor treatment. If the immunological response to vaccination is insufficient, it is possible to use virus-neutralizing monoclonal antibodies as a safe and effective method of primary prevention of COVID-19.

Пациенты с острыми лейкозами являются одной из наиболее уязвимых групп в отношении риска заражения SARS-CoV-2 и тяжелого течения коронавирусной инфекции. На протяжении первых 2 лет пандемии смертность пациентов с острыми лейкозами составляла 11-48 % в зависимости от типа лейкоза и лишь в 2022 г. Достигла популяционных значений. Факторами риска тяжелого течения COVID-19 у пациентов с острыми лейкозами являются пожилой возраст, сопутствующая кардиальная патология, метаболический синдром, а также отсутствие ремиссии острого лейкоза. Химиотерапевтическое лечение, проведенное за месяц до госпитализации с диагнозом COVID-19, показало статистическую значимость во влиянии на госпитальную летальность лишь в группе пациентов с острыми миелоидными лейкозами. Несмотря на это, международным медицинским сообществом рекомендовано отложить начало химиотерапии до полного регресса клинических симптомов коронавирусной инфекции и получения отрицательного результата теста на SARS-CoV-2 для всех типов лейкозов. В настоящее время наиболее оптимальной тактикой является профилактика заражения SARS-CoV-2 с помощью вакцинации пациентов с острыми лейкозами, получающих программное противоопухолевое лечение. При недостаточном иммунологическом ответе на вакцинацию возможно использование вируснейтрализующих моноклональных антител как безопасный и эффективный метод первичной профилактики COVID-19.

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