Impact of the first COVID-19 lockdown in Germany on the rate of acute infections during intensive chemotherapy for Hodgkin lymphoma.

in Infection by Anne Sophie Jacob, Helen Kaul, Michael Fuchs, Sarah Gillessen, Stefanie Kreissl, Annette Pluetschow, Jesko Momotow, Valdete Schaub, Andreas Huettmann, Mathias Haenel, Andreas Zimmermann, Judith Dierlamm, Julia Meissner, Stephan Mathas, Sonja Martin, Andreas Engert, Michael Hallek, Peter Borchmann, Clara Lehmann

TLDR

  • The study found a significant decrease in infections during chemotherapy for advanced-stage Hodgkin lymphoma during the COVID-19 lockdown, suggesting that COVID-19 protection measures can be effective in shielding patients from transmissible pathogens.

Abstract

Evidence on the effect of self-protection via social distancing and wearing face-masks on infections during chemotherapy is currently not available. We asked if the occurrence of acute infections during chemotherapy for advanced-stage Hodgkin lymphoma (HL) decreased when COVID-19 protection measures were in effect. We analyzed the occurrence of infections during all documented eBEACOPP cycles starting between 01 March and 30 June of 2017 to 2020 in patients treated within the GHSG HD21 study in Germany and compared the infection rates and characteristics by logistic regression models and means of descriptive statistics. We analyzed 911 cycles of 313 adult patients treated with 4 to 6 cycles of eBEACOPP. We found a significant decrease in the occurrence of infections during chemotherapy for HL during COVID-19 lockdown from 131 (19.6%) of 670 cycles in 2017-2019 to 30 (12.6%) of 239 cycles during COVID-19 lockdown [OR 0.574 (95% CI 0.354-0.930), P = 0.024]. The strongest effect was evident for unspecified infections with 39 cycles (5.8%) during 2017-2019 in comparison to 5 cycles (2.1%) during COVID-19 lockdown. 20 (24.1%) of 83 patients had an infection during the COVID-19 lockdown versus 99 (43.2%) of 229 patients in the years 2017-2019 (P = 0.0023). The significant decrease of infections during chemotherapy for HL during COVID-19 lockdown reveals the protective measures' potential to shield patients from transmissible pathogens. We conclude that these measures could be recommended for HL patients at risk for infections during chemotherapy.

Overview

  • The study investigated whether the implementation of COVID-19 protection measures, such as social distancing and face-masks, reduced the occurrence of acute infections during chemotherapy for advanced-stage Hodgkin lymphoma (HL).
  • The analysis focused on patients treated within the GHSG HD21 study in Germany, examining infection rates and characteristics during 911 cycles of eBEACOPP chemotherapy between March 2017 and June 2020.
  • The primary objective was to determine the effect of COVID-19 protection measures on the occurrence of infections during chemotherapy for HL and to explore potential recommendations for shielding patients from transmissible pathogens.

Comparative Analysis & Findings

  • The study found a significant decrease in the occurrence of infections during chemotherapy for HL during the COVID-19 lockdown, from 19.6% to 12.6%.
  • The strongest effect was observed for unspecified infections, with 5.8% of cycles experiencing infections during 2017-2019 compared to 2.1% during the COVID-19 lockdown.
  • The analysis revealed a significant reduction in infections during the COVID-19 lockdown (24.1% of patients) compared to pre-lockdown years (43.2% of patients)

Implications and Future Directions

  • The study suggests that COVID-19 protection measures could be recommended for HL patients at risk for infections during chemotherapy.
  • Future research could explore the specific characteristics of patients who benefit most from these measures, as well as the optimal duration and intensity of protection measures.
  • Additional studies may be necessary to determine the generalizability of these findings to other patient populations and cancer types.
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