Clinical characteristics of hematological patients concomitant with COVID‐19

The rapid spread of coronavirus disease 2019 (COVID‐19) represented the most serious issue to public health globally. Hematological patients as immunocompromised hosts are vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. There is little information available regarding the clinical features of hematological patients concomitant with COVID‐19. In this study, 9 concomitant patients were analyzed for their clinical manifestations, laboratory data, radiological findings, and immunologic features. The median age was 50 years (range, 17‐68 years) and 6 patients were male. Seven patients were infected through hospital‐associated transmission and other 2 through community‐associated transmission. Onset of COVID‐19 in all patients occurred during routine treatments for their hematological diseases. Eight patients were classified as moderate and 1 patient as critically ill COVID‐19. Four patients died, 1 from leukemia progression, 2 from life‐threatening secondary infection, and the other from respiratory failure caused by COVID‐19. Abruptly elevated levels of cytokines were often correlated with progressive hematological disease or concurrent bacterial infections. Two patients had atypical computed tomography (CT) imaging findings of COVID‐19. The median interval from the first CT scan imaging to improvement in survivors was 40 days (range, 14‐51 days). Four of 5 survivors had negative serological tests 1 month after symptom onset. Positive viral load in 4 survivors lasted longer than 45 days. Our results indicated concomitant patients formed a distinct subgroup characterized by atypical clinical features, defective viral clearance, and lower level of SARS‐CoV‐2‐specific Abs. Targeted therapies that impair host humoral immunity should be avoided. These findings will be helpful to tailor appropriate management for the concomitant patients.