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Jeremy S. Abramson, MD, MMSc
Jeremy S. Abramson, MD, MMSc
Posted: Friday, February 3, 2023
Patients with chronic lymphocytic leukemia (CLL) who tested positive for SARS–CoV-2 had milder infections and lower mortality rates when Omicron was the dominant variant, according to Christian Brieghel, MD, PhD, of Rigshospitalet, Copenhagen, and colleagues. The study comparing tests results from patients with CLL at hospital test sites with those of a larger population-based cohort of patients with CLL was published in the journal Blood.
The study analyzed patients with CLL who tested positive for SARS–CoV-2 between March 2020 and January 2022. The EHR (electronic health records) cohort included 151 patients with CLL who had a polymerase chain reaction (PCR)-confirmed COVID-19 infection in Eastern Denmark, whereas the population cohort consisted of 640 patients identified through the Danish CLL registry. Patients were grouped into four time periods based on the first positive SARS–CoV-2 PCR: period 1 was from March 2020 to December 2020; period 2 was from January 2021 to November 25, 2021; period 3 was November 26, 2021, to December 31, 2021; period 4 was from January 1, 2022, to January 28, 2022 (with the Omicron variant dominating from the end of period 3 and the Omicron BA.2 subvariant dominating in period 4).
Baseline characteristics among the four periods were similar. However, patients in the EHR cohort were significantly older than the population cohort. The rate of hospitalization for the EHR cohort was significantly higher in period 2 compared with periods 3 and 4. Anti–SARS–CoV-2 monoclonal antibodies were preemptively given during hospitalizations of patients with CLL and in the event of a positive SARS–CoV-2 PCR test. This, along with third and fourth booster vaccines, improved patient care.
The 30-day overall survival for the EHR cohort was higher than 75% in all four periods. The population cohort overall survival improved from 93.9% in period 1 to 99.2% in period 4. The combined cohorts demonstrated a significantly higher overall survival during period 4 compared with previous periods.
In light of these findings, the researchers recommend that “patients older than 70 with CLL and one or more comorbidities and hospital contact due to CLL or COVID-19 should be considered for closer monitoring and preemptive antiviral therapy upon a positive SARS–CoV-2 test.”
Disclosure: For full disclosures of the study authors, visit ashpublications.org.
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