@article{4cb9ae68b42b48bf8fe7d5d59df188a8,
title = "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",
abstract = "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. {\textcopyright} 2020, The Author(s), under exclusive licence to Springer Nature Limited.",
keywords = "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",
author = "L. Scarf{\`o} and T. Chatzikonstantinou and G.M. Rigolin and G. Quaresmini and M. Motta and C. Vitale and J.A. Garcia-Marco and J.{\'A}. Hern{\'a}ndez-Rivas and F. Mir{\'a}s and M. Baile and J. Marquet and C.U. Niemann and G. Reda and T. Munir and E. Gimeno and M. Marchetti and F.M. Quaglia and M. Varettoni and J. Delgado and S. Iyengar and A. Janssens and R. Marasca and A. Ferrari and C. Cu{\'e}llar-Garc{\'i}a and G. Itchaki and M. {\v S}pa{\v c}ek and {De Paoli}, L. and L. Laurenti and M.-D. Levin and E. Lista and F.R. Mauro and M. {\v S}imkovi{\v c} and {Van Der Spek}, E. and E. Vandenberghe and L. Trentin and E. Wasik-Szczepanek and R. Ruchlemer and D. Bron and {De Paolis}, M.R. and {Del Poeta}, G. and L. Farina and M. Foglietta and M. Gentile and Y. Herishanu and T. Herold and O. Jaksic and A.P. Kater and S. Kersting and L. Malerba and L. Orsucci and V.M. Popov and P. Sportoletti and M. Yassin and B. Pocali and G. Barna and A. Chiarenza and {dos Santos}, G. and E. Nikitin and M. Andres and M. Dimou and M. Doubek and A. Enrico and Y. Hakobyan and O. Kalashnikova and {Ortiz Pareja}, M. and M. Papaioannou and D. Rossi and N. Shah and A. Shrestha and O. Stanca and N. Stavroyianni and V. Strugov and C. Tam and M. Zdrenghea and M. Coscia and K. Stamatopoulos and G. Rossi and A. Rambaldi and E. Montserrat and R. Fo{\`a} and A. Cuneo and P. Ghia",
note = "Cited By :23 Export Date: 11 March 2021 CODEN: LEUKE Correspondence Address: Ghia, P.; Universit{\`a} Vita-Salute San Raffaele and IRCC Ospedale San RaffaeleItaly; email: ghia.paolo@hsr.it Correspondence Address: Stamatopoulos, K.; Institute of Applied Biosciences, Greece; email: kostas.stamatopoulos@certh.gr Chemicals/CAS: acalabrutinib, 1420477-60-6; azithromycin, 83905-01-5, 117772-70-0, 121470-24-4; bendamustine, 16506-27-7, 3543-75-7; chlorambucil, 305-03-3; cyclophosphamide, 50-18-0; fludarabine, 21679-14-1; hydroxychloroquine, 118-42-3, 525-31-5; ibrutinib, 936563-96-1; idelalisib, 1146702-54-6, 870281-82-6; obinutuzumab, 949142-50-1; rituximab, 174722-31-7; venetoclax, 1257044-40-8; zanubrutinib, 1691249-45-2; Antineoplastic Agents; PCI 32765; Protein Kinase Inhibitors; Pyrazoles; Pyrimidines Funding details: RF-2018-12368231 Funding details: AstraZeneca Funding details: Gilead Sciences Funding details: Janssen Biotech Funding details: Celgene Funding details: AbbVie Funding details: Roche Italia Funding details: Associazione Italiana per la Ricerca sul Cancro, AIRC, 143 GCH-CLL, 179 NOVEL, 20246, 21198, 5041673 Funding text 1: CUN received research support and/or honoraria from Abbvie, AstraZeneca, CSL Behring, Janssen, and Sunesis. GR received honoraria from AbbVie, Gilead, Janssen. EG received travel grants, honoraria as consultant and/or speaker bureau from Janssen, Abbvie, Roche, and Gilead. MoMo received consultant fees from Gilead. MV received honoraria for Advisory boards from Janssen and Roche. SI received Honoraria Janssen and Gilead. AJ received travel grants, speaker fees or consultancies: Amgen, Abbvie, Celgene, Janssen, Gilead, Novartis, Sanofi-Genzyme, Roche. AF received honoraria from AbbVie. MaSp received honoraria from AbbVie, Gilead, and Janssen. ML received honoraria for Advisory board and travel compensation from Janssen, Abbvie, and Roche. EVDS received compensation for teaching activities from Amgen. EV received travel grants from Abbvie, Gilead, Jannsenns, and Roche, research grants from Abbvie, Gilead, and Roche. LF received honoraria from AbbVie, Janssen (Advisory role or Lecturer). MF received honoraria from Abbvie, Janssen, Gilead. YH received honoraria from AbbVie, AstraZeneca, Janssen, Medison, Sanofi, and Roche. OJ received Honoraria from Abbvie, Janssen, and Roche. APK received research support: Abbvie, Janssen, Roche/Genentech, AstraZeneca; Adboard: Abbvie, Janssen, Roche/Genentech, AstraZeneca; speakersfee: Jans-sen, AstraZeneca, Abbvie. SK received Travel grant from Celgene, research funding from Janssen, Abbvie. MA received travel support and advisory boards from AbbVie, Janssen-Cilag, Celgene, Novartis. DR received honoraria from Abbvie, AstraZeneca, Gilead, Janssen, Loxo, and Verastem, and research grants from Abbvie, AstraZeneca, Cellestia, Gilead, Janssen. NS received consulting fees from AbbVie, Roche, Janssen. CT received honorarium and research funding from Janssen, Beigene, and Abbvie. MC received research funding from Janssen and Karyopharm Therapeutics, and personal fees from Jans-sen, Gilead, Abbvie, and Shire, outside the submitted work. KS received honoraria from Abbvie, Acerta/AstraZeneca, Gilead, Janssen, and research funding from Abbvie, Gilead, Janssen. AC received honoraria from AbbVie, AstraZeneca, Gilead, Janssen. RF received honoraria from Abbvie, Gliead, Janssen, AstraZeneca, Amgen, Incyte, Novartis. PG received honoraria from AbbVie, Adaptive, Acerta/ AstraZeneca, ArQule, BioGene, Dynamo, Gilead, Janssen, MEI, Sunesis, and Research funding from AbbVie, Gilead, Janssen, Sunesis. TC, GQ, FM, MB, JM, TM, FMQ, JD, RM, CC, GI, LDP, LL, EL, FRM, MaSi, LT, EW, RR, DB, MRDP, GDP, MG, TH, LM, LO VMP, PS, MY, BP, GB, AC, GdS, EN, MaDi, MiDo, AE, YH, OK, MOP, MP, AS, OA, NS, VS, MZ, GR, AR, EM have no conflict of interest to disclose. Funding text 2: Conflict of interest LS received honoraria from AbbVie, AstraZeneca, Gilead, Janssen. GMR received honoraria from Abbvie, Gliead, and Janssen and research funding from Gilead. MaMo received onoraria from Janssen and Roche. CV received consultancy fees from Janssen, outside the submitted work. JAG received honoraria from AbbVie, AstraZeneca, Gilead, Janssen, and Roche. Research funding from AbbVie, Gilead, and Janssen. JAH received honoraria for lectures and Advisory Boards from Janssen, Abbvie, Roche, Gilead, AstraZeneca. Funding text 3: Acknowledgements This work was in part supported by Associazione Italiana per la Ricerca sul Cancro—AIRC, Milano, Italy (Investigator Grant #20246 and Special Program on Metastatic Disease—5 per mille #21198); ERA NET TRANSCAN-2 Joint Transnational Call for Proposals: JTC 2014 (project #143 GCH-CLL) and JTC 2016 (project #179 NOVEL), project code (MIS) 5041673; Bando della Ricerca Finalizzata 2018, Ministero della Salute, Roma, Italy (pro-getto RF-2018-12368231); the SARS-CoV-2 research mission of the Greek Secretariat for Research and Technology; BEAT Leukemia and AIL-FE.",
year = "2020",
doi = "10.1038/s41375-020-0959-x",
language = "English",
volume = "34",
pages = "2354--2363",
journal = "Leukemia",
issn = "0887-6924",
publisher = "Springer Nature",
number = "9",
}