Clinical Characteristics and Outcome of 31 Cases with Covid-19 Diagnosed in Haematology Units in Wuhan, China: A Retrospective Cohort Study
44 Pages Posted: 24 Mar 2020More...
Background: The severe acute respiratory coronavirus 2 (SARS-CoV-2) has caused a pandemic, but data about hospital-associated infection are scarce. We aimed to describe epidemical and clinical features and outcome of SARS-CoV-2 pneumonia (COVID-19) diagnosed in haematological units, including patients with haematological disorders (HD) and health professionals.
Methods: In this retrospective study, we enrolled all the hospitalized patients and medical staff, from January 23 to February 14, at three haematology centres (two in Wuhan, the capital of Hubei and centre of the outbreak; one in Xiangyang, another city in Hubei). Hospitalized patients and medical staff diagnosed with COVID-19 were eligible without additional restriction, with medical records reviewed and data collected.
Findings: There were 31 cases with COVID-19 diagnosed in Wuhan cohorts, with no cases in Xiangyang cohort. Of the 136 hospitalized HD patients and 224 medical staff in Wuhan, 15 (11%, HD cases) and 16 (7·1%, non-HD cases) were diagnosed, respectively, and 13 (86·7%) of the 15 HD cases were patients with haematological malignancies. There was a cluster infection related to intensive care unit. Compared to non-HD cases, HD cases showed significantly more fever, cough, and dyspnoea, higher procalcitonin and c-reactive protein levels, and lower lymphocyte, platelet, and haemoglobin levels ( P < ·001). All the severe or critical cases and non-survivors with COVID-19 were HD cases. Rapid progression with a higher incidence (60% vs 0%) of acute respiratory depression syndrome was detected in non-survivors, with a median survival of 12 (range, 6-29) days from symptom onset of COVID-19, as of February 29.
Interpretation: In haematological units, hospitalized HD patients and medical staff are both at high risk of COVID-19 under an outbreak in Wuhan, partially attributing to hospital-associated transmission. The HD patients are characterized by great respiratory, inflammatory and haematological damages and extremely poor prognosis.
Declaration of Interest: We declare no competing interests.
Ethical Approval: This study was approved by the Medical Ethics Committee of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (20200062).
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