The Single-Center Analysis of Survival and Mortality in Patients with Hematological Diseases and COVID-19 in Russia

Background: By 11/03/2020, the WHO had declared the COVID-19 outbreak a pandemic. At 25/05/2020 Russia ranked third by the incidence of COVID-19 and the number of confirmed cases was 344,481 with 3,541(1%) deaths. Aim: To describe the epidemiological characteristics and survival of patients with hematological diseases (HD) and COVID-19. Patients: Between 20/04/2020-25/05/2020, all hospitalized patients at NRCH were tested for COVID-19 before hospitalization and with once-weekly follow-up (or in case of fever). Nasal swab samples were studied by RT-PCR. The study population included 46 patients (pts) with HD and confirmed SARS-CoV-2. All pts were observed at ten departments. 15 pts who shared the same wards (3-4 patients in one ward) at one department were infected. Ten infected pts resided in single-bed wards and 21 pts were observed at the outpatient department. All pts with positive SARS-CoV-2 were treated either in COVID-19-specialized centers (29 (63%) pts) or at home (17 (37%) pts). Results: The most common symptom at the onset of illness was fever (26 (57%) pts), the other pts were asymptomatic. Pneumonia was diagnosed in 27 pts. All 17 pts who were treated at home recovered. Out of 8 pts who required treatment at the ICU, 5 pts died. Thirty-eight pts were treated without ICU (1 pt died due to sudden death). As of 25/05/2020, 10 out of 29 pts were still hospitalized. Totally, 13 pts were discharged, and 6 pts died. Out of the 8 pts who were admitted to the ICU, 1 pt was still at the ICU, 1 pt was discharged and returned home, 1 pt was transferred to the general wards, and 5 pts died. Six (13%) of 46 pts required IMV; of them, 5 pts died and 1 pt still remains. Conclusion: In this single-center analysis of 46 pts with HD and confirmed SARS-CoV-2, 1-month OS was 82%, the median follow-up was 18 days, and mortality was 13%. Compared to the general population with COVID-19 in Russia, the mortality in patients with HD was higher (13% vs 1%) with the comparable median age (40 vs 45 years). The COVID-19 pandemic dictates new epidemiological conditions for the management of pts with HD: mandatory SARS-CoV-19 testing in all pts before hospitalization followed by weekly testing, treatment in single-room wards and compliance with strict epidemiological measures.