532 - COVID-19 Pneumonia in Patients with Hematologic Malignancies – A Report from the US Epicenter

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Presenting Author(s)

MP

Markus Plate

Instructor of Medicine/ Attending Physician
Weill Cornell Medical College/ New York Presbyterian Hospital , New York
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

RK

Rosy Priya Kodiyanplakkal

Assistant Professor of Clinical Medicine
Weill Cornell Medicine, NewYork-Presbyterian Hospital
New York, New York
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Michael J. Satlin

Associate Professor
Weill Cornell Medicine
New York, NY
Disclosure: Achaogen (Consultant)Allergan (Grant/Research Support)Merck (Grant/Research Support)Shionogi Inc. (Consultant)
RS

Rosemary Soave

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AD

Alexander Christian. Drelick

Assistant Professor
Weill Cornell Medicine, NewYork-Presbyterian Hospital
New York, New York
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NO

Nina Orfali

Fellow in Hematology/Oncology
Weill Cornell Medicine
New York, New York
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
DH

David Helfgott

Assistant Professor of Medicine
Weill Cornell Medicine
New York, New York
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
RN

Ruben Niesvizky

Professor of Medicine
Weill Cornell Medicine
New York, New York
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
GR

Gail J Roboz

Professor of Medicine
Weill Cornell Medicine
New york, New York
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
TS

Tsiporah B Shore

Professor of Medicine
Weill Cornell Medicine
New York, New York
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
KV

Koen Van Besien

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CS

Catherine B Small

Assistant Professor
NYP Weill Cornell Medicine
New York, New York
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
TW

Thomas J. Walsh

Professor of Medicine, Pediatrics, Microbiology and Immunology
Weill Cornell Medicine and NYPH
New York, New York
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: Limited data are available for risk assessment and outcome of COVID-19 in patients with hematologic malignancies (HM). We present a single center study of COVID-19 pneumonia in a cohort of 31 patients with HM.

Methods: Data were abstracted from electronic medical records for patients admitted to NYPH between 3/5/20 and 4/17/20 and entered into a REDCap database.

Results: Twenty (64.5%) were male; median age was 71 years. There were 8 patients with Multiple Myeloma (MM), 8 with Chronic Lymphocytic Leukemia (CLL), 6 (19.4%) had AML, 5 (16.1%) NHL, 2 (3.2%) ALL; CML, MDS and Polycythemia Vera occurred in 1 patient each. Twenty-four (77.4%) had active HM; 6 (19.4%) were in remission; and 1 relapsed. Nineteen patients (61.3%) received recent chemotherapy and 11 (35.5%) immunosuppressive therapies. There were 7 (22.6%) hematopoietic stem cell transplant (HSCT) recipients (4 allogeneic and 3 autologous). Comorbidities were evenly distributed among all malignancies: 18 (58.1%) had hypertension, 9 (38.7%) obesity, 7 (22.6%) diabetes mellitus, and 11 (35.5%) were former smokers. The most common symptoms included cough (90.3%), fever (83.9%) and dyspnea (61.3%); 7 (22.6%) had nausea and vomiting; 7 (22.6%) had diarrhea. On presentation, hypoxia (O2 sat ≤94% on room air) occurred in 64.5%; median ALC was 330/ml; 23 (74.2%) had ALC< 1000/ml; median CRP was 15.9 mg/dl (2.5-40.4), ferritin 1162 ng/ml (264 - > 16500), and D-dimers 456 ng/ml (< 150-2418). Thirteen patients (41.9%) required ICU admission and were intubated; among those 9 (69.2%) had either MM or CLL. Co-infections were uncommon; two patients developed HSV1 pneumonitis and one of these also had CMV pneumonitis. Twenty-eight (90.3%) were treated with hydroxychloroquine, 5 (16.1%) remdesivir, 2 (6.5%) tocilizumab, 1 (3.2%) sarilumab, and 4 (12.9%) with methylprednisolone 0.5mg/kg Q12h. Seventeen patients (54.8%) recovered and were discharged, 12 (38.7%) died; 2 (6.5%) were still hospitalized but left the ICU.

Conclusion: In our cohort, there were predominantly more patients with MM and CLL and 56% of these were intubated; larger cohort studies will further define the risk and outcome for COVID-19 in patients with HM.