Clinical characteristics and risk factors associated with COVID-19 severity in patients with haematological malignancies in Italy: a retrospective, multicentre, cohort study

SPS commentary:

The researchers say their findings highlight the need for aggressive infection prevention strategies, at least until effective vaccination or treatment strategies are available.

 

A commentary advises caution in interpreting these findings as the composition of the cohort, 84% of whom were inpatients, suggests bias in enrolment favouring patients with severe disease; the relatively low rate of ICU admission (18%) might reflect rationing of health-care resources away from patients in the cohort (and was well documented in northern Italy during enrolment period); and the high mortality reported in patients with mild disease (18%) is inconsistent with previous studies. It adds that the model reported does not adjust for several known risk factors for COVID-19 mortality, such as smoking and functional status and the short median follow-up interval of 20 days highlights that the associations identified are with early mortality and might not reflect an entire COVID-19 course; although it remains too early in the pandemic to collect mature long-term outcome data. It concludes that this research advances understanding of the unique risks the COVID-19 pandemic poses to patients with haematological malignancies, and although it is appropriate to fear COVID-19, as many health-care systems return to normalcy, deferring treatment is not the optimal response.