COVID-19 severity and mortality in patients with chronic lymphocytic leukemia: a joint study by ERIC, the European Research Initiative on CLL, and CLL Campus

L. Scarfò, T. Chatzikonstantinou, G.M. Rigolin, G. Quaresmini, M. Motta, C. Vitale, J.A. Garcia-Marco, J.Á. Hernández-Rivas, F. Mirás, M. Baile, J. Marquet, C.U. Niemann, G. Reda, T. Munir, E. Gimeno, M. Marchetti, F.M. Quaglia, M. Varettoni, J. Delgado, S. IyengarA. Janssens, R. Marasca, A. Ferrari, C. Cuéllar-García, G. Itchaki, M. Špaček, L. De Paoli, L. Laurenti, M.-D. Levin, E. Lista, F.R. Mauro, M. Šimkovič, E. Van Der Spek, E. Vandenberghe, L. Trentin, E. Wasik-Szczepanek, R. Ruchlemer, D. Bron, M.R. De Paolis, G. Del Poeta, L. Farina, M. Foglietta, M. Gentile, Y. Herishanu, T. Herold, O. Jaksic, A.P. Kater, S. Kersting, L. Malerba, L. Orsucci, V.M. Popov, P. Sportoletti, M. Yassin, B. Pocali, G. Barna, A. Chiarenza, G. dos Santos, E. Nikitin, M. Andres, M. Dimou, M. Doubek, A. Enrico, Y. Hakobyan, O. Kalashnikova, M. Ortiz Pareja, M. Papaioannou, D. Rossi, N. Shah, A. Shrestha, O. Stanca, N. Stavroyianni, V. Strugov, C. Tam, M. Zdrenghea, M. Coscia, K. Stamatopoulos, G. Rossi, A. Rambaldi, E. Montserrat, R. Foà, A. Cuneo, P. Ghia

Research output: Contribution to journalArticlepeer-review


Chronic lymphocytic leukemia (CLL) is a disease of the elderly, characterized by immunodeficiency. Hence, patients with CLL might be considered more susceptible to severe complications from COVID-19. We undertook this retrospective international multicenter study to characterize the course of COVID-19 in patients with CLL and identify potential predictors of outcome. Of 190 patients with CLL and confirmed COVID-19 diagnosed between 28/03/2020 and 22/05/2020, 151 (79%) presented with severe COVID-19 (need of oxygen and/or intensive care admission). Severe COVID-19 was associated with more advanced age (≥65 years) (odds ratio 3.72 [95% CI 1.79–7.71]). Only 60 patients (39.7%) with severe COVID-19 were receiving or had recent (≤12 months) treatment for CLL at the time of COVID-19 versus 30/39 (76.9%) patients with mild disease. Hospitalization rate for severe COVID-19 was lower (p < 0.05) for patients on ibrutinib versus those on other regimens or off treatment. Of 151 patients with severe disease, 55 (36.4%) succumbed versus only 1/38 (2.6%) with mild disease; age and comorbidities did not impact on mortality. In CLL, (1) COVID-19 severity increases with age; (2) antileukemic treatment (particularly BTK inhibitors) appears to exert a protective effect; (3) age and comorbidities did not impact on mortality, alluding to a relevant role of CLL and immunodeficiency. © 2020, The Author(s), under exclusive licence to Springer Nature Limited.
Original languageEnglish
Pages (from-to)2354-2363
Number of pages10
Issue number9
Publication statusPublished - 2020


  • acalabrutinib
  • azithromycin
  • bendamustine
  • chlorambucil
  • cyclophosphamide
  • fludarabine
  • hydroxychloroquine
  • ibrutinib
  • idelalisib
  • obinutuzumab
  • rituximab
  • venetoclax
  • zanubrutinib
  • antineoplastic agent
  • protein kinase inhibitor
  • pyrazole derivative
  • pyrimidine derivative
  • adult
  • aged
  • aging
  • Article
  • chronic lymphatic leukemia
  • clinical outcome
  • cohort analysis
  • comorbidity
  • comparative study
  • coronavirus disease 2019
  • disease association
  • disease course
  • disease severity
  • drug withdrawal
  • Europe
  • female
  • hospital admission
  • hospitalization
  • human
  • immune deficiency
  • intensive care unit
  • major clinical study
  • male
  • mortality rate
  • multicenter study
  • oxygen therapy
  • predictor variable
  • priority journal
  • retrospective study
  • treatment duration
  • age
  • Betacoronavirus
  • clinical trial
  • complication
  • Coronavirus infection
  • middle aged
  • mortality
  • pandemic
  • pathology
  • prognosis
  • questionnaire
  • severity of illness index
  • very elderly
  • virus pneumonia
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents
  • Comorbidity
  • Coronavirus Infections
  • Female
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Male
  • Middle Aged
  • Pandemics
  • Pneumonia, Viral
  • Prognosis
  • Protein Kinase Inhibitors
  • Pyrazoles
  • Pyrimidines
  • Retrospective Studies
  • Severity of Illness Index
  • Surveys and Questionnaires


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