Clinical Characteristics and Outcomes of COVID-19 in Turkish Patients

Abstract

Objective: Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. Materials and Methods: In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection. Results: Forty four patients were asymptomatic at diagnosis of SARSCoV-2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixtynine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use. Conclusion: Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.

C1 [Bozdag, Sinem Civriz; Seval, Guldane Cengiz; Toprak, Selami Kocak; Beksac, Meral; Topcuoglu, Pervin; Yuksel, Meltem Kurt; Ilhan, Osman; Ozcan, Muhit; Gurman, Gunhan] Ankara Univ, Dept Hematol, Fac Med, Ankara, Turkey.

[Hindilerden, Ipek Yonal] Istanbul Univ, Istanbul Fac Med, Dept Internal Med, Istanbul, Turkey.

[Hindilerden, Fehmi] Istanbul Bakirkoy Sadi Konuk Training & Res Hosp, Clin Hematol, Istanbul, Turkey.

[Andic, Neslihan; Gunduz, Eren; Teke, Hava Uskudar] Eskisehir Osmangazi Univ, Dept Hematol, Fac Med, Eskisehir, Turkey.

[Baydar, Mustafa; Guven, Zeynep Tugba; Celik, Serhat; Keklik, Muzaffer; Kaynar, Leylagul] Erciyes Univ, Dept Internal Med, Fac Med, Kayseri, Turkey.

[Kaynar, Lale Aydin; Ozkurt, Zubeyde Nur; Yagci, Munci; Yegin, Zeynep Arzu] Gazi Univ, Dept Hematol, Fac Med, Ankara, Turkey.

[Goksoy, Hasan Sami; Abishov, Elgun; Abbasov, Hamza; Sadri, Sogol] Yeni Yuzyil Univ, Ozel Gaziosmanpasa Hosp, Dept Internal Med, Div Hematol, Istanbul, Turkey.

[Aydin, Berrin Balik; Mutlu, Yasa Gul; Sadri, Sevil; Bekoz, Huseyin Saffet; Sevindik, Omur Gokmen] Medipol Univ, Dept Internal Med, Fac Med, Istanbul, Turkey.

[Demirci, Ufuk; Bas, Volkan; Demir, Ahmet Muzaffer] Trakya Univ, Dept Hematol, Fac Med, Edirne, Turkey.

[Can, Ferda] Ankara City Hosp, Dept Hematol, Clin Internal Med, Ankara, Turkey.

[Ozkocaman, Vildan; Ozkalemkas, Fahir] Bursa Uluda Univ, Dept Internal Med, Div Hematol, Fac Med, Bursa, Turkey.

[Demircioglu, Sinan; Ceneli, Ozcan] Necmettin Erbakan Univ, Meram Fac Med, Dept Hematol, Konya, Turkey.

[Ince, Idris] Dr Ersin Arslan Training & Res Hosp, Clin Hematol, Gaziantep, Turkey.

[Yilmaz, Umut; Ar, Muhlis Cem] Istanbul Univ Cerrahpasa, Cerrahpasa Fac Med, Dept Internal Med, Div Hematol, Istanbul, Turkey.

[Kucukdiler, Hilal Eroglu; Selim, Cem; Yavasoglu, Irfan; Bolaman, Ali Zahit] Adnan Menderes Univ, Dept Hematol, Fac Med, Aydin, Turkey.

[Yavuz, Boran; Ozsan, Guner Hayri] Dokuz Eylul Univ, Dept Hematol, Fac Med, Izmir, Turkey.

[Atas, Unal; Yucel, Orhan Kemal] Akdeniz Univ, Dept Hematol, Fac Med, Antalya, Turkey.

[Gursoy, Vildan] Bursa City Hosp, Clin Hematol, Bursa, Turkey.

[Ciftciler, Rafiye] Aksaray Training & Res Hosp, Clin Hematol, Aksaray, Turkey.

[Albayrak, Canan] Ondokuz Mayis Univ, Dept Pediat Hematol, Fac Med, Samsun, Turkey.

[Guler, Nil; Erol, Veysel] Pamukkale Univ, Dept Internal Med, Fac Med, Denizli, Turkey.

[Terzi, Hatice] Cumhuriyet Univ, Dept Hematol, Fac Med, Sivas, Turkey.

[Dogan, Ali] Van Yuzuncu Yil Univ, Dept Hematol, Fac Med, Van, Turkey.

[Aksu, Tekin; Cangul, Sule Unal] Hacettepe Univ, Dept Pediat Hematol, Fac Med, Ankara, Turkey.

[Maral, Senem] Univ Hlth Sci Turkey, Diskapi Yildirim Beyazit Training & Res Hosp, Dept Hematol, Ankara, Turkey.

[Akyay, Arzu] Inonu Univ, Dept Pediat Hematol & Oncol, Fac Med, Malatya, Turkey.

[Yavuz, Yasemin] Ankara Univ, Dept Biostat, Sch Med, Ankara, Turkey.

[Kucukkaya, Reyhan Diz] Istanbul Univ, Fac Sci, Dept Mol Biol & Genet, Istanbul, Turkey.