The results of the complex therapy of hemoblastoses with COVID-19: Single-center experience at the CVI-1 Department of the National Research Oncology Center (Astana, Kazakhstan)

Abstract

Relevance: The SARS-Cov2 pandemia caused an unparalleled health crisis that directly affected the course and treatment of patients with hemoblastosis. Hematologists faced an extraordinarily challenging situation due to the administered chemotherapy along with the treatment of the concomitant infectious pathology of coronavirus infection (CVI). However, there were no clear recommendations and approved protocols for diagnosis and treatment for this category of patients for the described period. Patients with hematological malignancies are generally more susceptible to infections due to immunosuppression caused by their disease and the deteriorating effect of treatment on the immune system. 
The study aimed to investigate and analyze the impact of the SARS-Cov-2 viral infection on mortality from oncohematological diseases.
Methods: Data for the retrospective cohort study was obtained from patient electronic medical records. CVI was confirmed by a positive PCR test for SARS-Cov-2 RNA and chest computed tomography. All patients underwent a determination of the disease status at the time of admission to the department. Further, the therapy performed was estimated, and a descriptive analysis of the treatment results was carried out.
Results: From July 2020 to July 2021, 56 patients with hemoblastosis and hematopoietic depression with concomitant CVI were treated in the CVI-1 department of the National Research Oncology Center (Astana, Kazakhstan). During this period, 2 patients died, and the mortality rate was 3.6%, while at the specialized hematology department, the mortality rate in 2020 amounted to 2.9% (26 deaths per 904 patients).
Conclusion: Our department’s results conclude that without systemic antitumor therapy for hemoblastosis and achieving remission, the treatment of infectious complications will be ineffective. SARS-CoV-2 infection during or after systemic anticancer therapy does not dramatically affect mortality from COVID-19.