Patients with CLL have a lower risk of death from COVID-19 in the Omicron era

  1. Carsten U. Niemann
  2. Caspar da Cunha-Bang
  3. Marie Helleberg
  4. Sisse R. Ostrowski
  5. Christian Brieghel

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Abstract

Previous studies have shown that patients with chronic lymphocytic leukemia (CLL) and coronavirus disease 2019 (COVID-19) have high mortality rates. Infection with the Omicron variant has been described as a milder disease course in the general population. However, the outcome for immunocompromised patients has not previously been reported. In a cohort of patients with CLL tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at hospital test sites in the time periods before and after dominance of the Omicron variant, rates of hospitalizations and intensive care unit admissions declined significantly, whereas 30-day mortality remained as high as 23% in the period with dominance of the Omicron sublineage BA.2 variant. However, for a larger population-based cohort of patients with CLL (including the hospital cohort), 30-day mortality was 2%. Thus, patients with CLL with close hospital contacts and, in particular, those >70 years of age with 1 or more comorbidities should be considered for closer monitoring and preemptive antiviral therapy upon a positive SARS-CoV-2 test.

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  1. Version published to 10.1182/blood.2022016147
  2. ScreenIT

    SciScore for 10.1101/2022.03.01.22271685: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The study was approved by the Ethics Committee and Data Protection Agency.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Limitations apply to this study; the size of the patient population was limited, patients with CLL testing positive for SARS-CoV-2 at test sites not reported within the EHR may represent less severe CLL, thus causing overrepresentation of patients with more aggressive CLL in this study. Based on epidemiological data from South Africa,17 the incidence of SARS-CoV-2 seems decoupled from the incidences of hospitalization and death upon emergence of the omicron variant, while previous vaccination seems not to protect against infection with the omicron variant of SARS-CoV-2. This study indicate that omicron sublineage BA.2 pose a similar risk of fatal COVID-19 for patients with impaired immune function due to CLL and/or treatment,3,18 with an estimated 30-day OS rate of 77%, as prior variants. Thus, patients above 70 with CLL and one or more comorbidities should be considered for closer monitoring and pre-emptive antiviral therapy upon a positive SARS-CoV-2 test.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2022.03.01.22271685v1 on medRxiv