Clinical Characteristics of Hematological Patients Concomitant with COVID-19.

The rapid spread of COVID-19 represented the most serious issue to public health globally. Hematological patients as immunocompromised hosts are vulnerable to SARS-CoV-2 infection. There is rare information available regarding the clinical features of hematological patients concomitant with COVID-19. In this study, 9 concomitant patients were analyzed for their clinical manifestations, the laboratory data, radiological findings and immunologic features. The median age was 50 years (range, 17-68) and 6 patients were male. 7 patients were infected via hospital-associated transmission and other 2 via community-associated transmission. Onset of COVID-19 in all patients occurred during routine treatments for their hematological diseases. 8 patients were classified as moderate and 1 patient as critically ill COVID-19. 4 patients died, 1 from leukemia progression, 2 from life-threatening secondary infection and the other one from respiratory failure caused by COVID-19. Abruptly elevated level of cytokines was often correlated with progressive hematological disease or concurrent bacterial infections. 2 patients had the atypical CT imaging findings of COVID-19. The median interval from the first CT scan imaging to improvement in survivors was 40 days (range 14-51 days). 4 out of 5 survivors had negative serological tests one month after symptoms onset. Positive viral load in 4 survivors lasted longer than 45 days. Our result indicated concomitant patients formed a distinct subgroup characterized by atypical clinical features, defective viral clearance and lower level of SARS-CoV-2-specific antibodies. Targeted therapies that impair host humoral immunity should be avoided. These findings will be helpful to tailor appropriate management for the concomitant patients.