Long-Term Outcomes of COVID-19 and Risk Factors for Prolonged or Persistent COVID-19 in Lymphoma Patients: A Multicenter, Retrospective Cohort Study.

in Journal of Korean medical science by Jung Ah Lee, Min Han, Sangmin Ahn, Yongseop Lee, Joon-Sup Yeom, Jun Yong Choi, Nam Su Ku, Su Jin Jeong, Jung Ho Kim, Jin Seok Kim, Haerim Chung, Hyunsoo Cho, Yu Ri Kim, Jin Young Ahn

TLDR

  • This study looked at how long COVID-19 lasts in people with lymphoma, a type of cancer. They found that people who received a certain treatment for their lymphoma were more likely to have COVID-19 last longer. They also found that having COVID-19 last longer was linked to a higher chance of dying within a year. This study is important because it helps us understand how to better care for people with lymphoma who get COVID-19.

Abstract

Patients with hematologic malignancies exhibit persistent severe acute respiratory syndrome coronavirus 2 positivity over long periods after coronavirus disease 2019 (COVID-19) diagnosis. However, the frequency of, risk factors for, and prognosis of prolonged COVID-19 in immunocompromised patients remain unclear. Therefore, we investigated the long-term outcomes of COVID-19 in lymphoma patients and identified the associated factors and impact of prolonged COVID-19 on mortality. A multicenter retrospective cohort study of 583 lymphoma patients was conducted in 3 tertiary hospitals in South Korea. Patients receiving lymphoma treatment who were quarantined after obtaining a diagnosis of COVID-19 by polymerase chain reaction (PCR) or antigen test from August 2021 to September 2022 were examined. Overall, 115 patients (19.7%) were diagnosed with COVID-19. Among 77 patients with clinical data, 24 had prolonged COVID-19. Patients in the prolonged COVID-19 group showed higher rates of receiving rituximab maintenance therapy following bendamustine and rituximab (BR) treatment for follicular lymphoma. This group did not show significant differences in clinical presentation within 30 days of COVID-19 diagnosis; however, it showed higher rates of re-admission due to COVID-19 pneumonia compared with the non-prolonged COVID-19 group. BR treatment followed by rituximab maintenance therapy is one of the risk factors for persistent PCR positivity, delayed or persistent pneumonia, and COVID-19 related admission after quarantine period. Prolonged COVID-19 was an independent risk factor for 1-year mortality. Prolonged COVID-19 was more frequent in lymphoma patients who received BR treatment followed by rituximab maintenance therapy and associated with unfavorable long-term outcomes and higher 1-year mortality.

Overview

  • The study investigates the long-term outcomes of COVID-19 in lymphoma patients and identifies associated factors and impact of prolonged COVID-19 on mortality.
  • The study is a multicenter retrospective cohort study of 583 lymphoma patients in South Korea.
  • The primary objective of the study is to investigate the long-term outcomes of COVID-19 in lymphoma patients and identify associated factors and impact of prolonged COVID-19 on mortality.

Comparative Analysis & Findings

  • The study found that patients in the prolonged COVID-19 group showed higher rates of receiving rituximab maintenance therapy following bendamustine and rituximab (BR) treatment for follicular lymphoma.
  • The study found that patients in the prolonged COVID-19 group did not show significant differences in clinical presentation within 30 days of COVID-19 diagnosis; however, it showed higher rates of re-admission due to COVID-19 pneumonia compared with the non-prolonged COVID-19 group.
  • The study found that BR treatment followed by rituximab maintenance therapy is one of the risk factors for persistent PCR positivity, delayed or persistent pneumonia, and COVID-19 related admission after quarantine period. Prolonged COVID-19 was an independent risk factor for 1-year mortality.

Implications and Future Directions

  • The study highlights the importance of monitoring lymphoma patients for prolonged COVID-19 and identifying associated factors to improve their outcomes.
  • The study suggests that further research is needed to investigate the long-term effects of BR treatment followed by rituximab maintenance therapy on COVID-19 outcomes in lymphoma patients.
  • The study emphasizes the need for clinical trials to evaluate the effectiveness of different treatment regimens for COVID-19 in immunocompromised patients, including those with lymphoma.
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