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Clinical Characteristics, Diagnosis, and Clinical Management of COVID-19 in Fifteen Patients with Haematological Disease – A Retrospective Analysis
18 Pages Posted: 22 Apr 2020
More...Abstract
BACKGROUND: The aim of the present study was to summarize clinical and laboratory characteristics of coronavirus disease 2019 (COVID-19) in patients with haematological disease, share the experiences of diagnosis and treatment, and provide a reference for future management of this special population.
METHODS: Clinical data of fifteen COVID-19 in patients with haematological disease were retrospectively analysed.
FINDINGS: Fifteen patients were enrolled, two had acute myeloid leukaemia, five had B-cell acute lymphoblastic leukaemia, two had multiple myeloma, two had chronic lymphocytic leukaemia, one had severe aplastic anaemia, one had follicular lymphoma,and two had myelodysplastic syndrome. Patients were classified as severe (7 cases) or critical (7 cases) or moderate (1 case) disease, with 8 survivors and 7 non-survivors. The median duration of viral shedding was 21·5 days (range10~29) in survivors. The median duration of death was 9 days (range 1~20) in non-survivors. Laboratory indicators and image findings on computed tomography were more atypical and more diverse compared to general population. Comprehensive treatment, including oxygen inhalation, anti-infection, antiviral and psychological counselling were given. Immunosuppressive agents and intense chemotherapy were temporarily discontinued. Ruxolitinib and hydroxychloroquine showed their potential advantages in some certain situations.
INTERPRETATION: COVID-19 in patients with haematological disease present atypical, severe symptoms and high mortality rates. During the epidemic, refined and personalized clinical management is necessary to decrease infection rate and reduce mortality effectively.
FUNDING STATEMENT: This study was supported by a grant from the Key Special Project of Ministry of Science and Technology, China(No.2020YFC0845700).
DECLARATION OF INTERESTS: The authors declare no competing interests.
ETHICS APPROVAL STATEMENT: The study was approved by the Medical Ethical Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. The requirement for informed consent was waived by the Ethics Commission.
Keywords: SARS-CoV-2; COVID-19; Hematological Disease; Diagnosis; Treatment
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