COVID-19 severity and mortality in patients with chronic lymphocytic leukemia: a joint
study by ERIC, the European Research Initiative on CLL, and CLL Campus
Chronic lymphocytic leukemia (CLL) is a disease of the elderly, characterized by immunodeficiency.
Hence, patients with CLL might be considered more susceptible to severe complications
from COVID-19. We undertook this retrospective international multicenter study to
characterize the course of COVID-19 in patients with CLL and identify potential predictors
of outcome. Of 190 patients with CLL and confirmed COVID-19 diagnosed between 28/03/2020
and 22/05/2020, 151 (79%) presented with severe COVID-19 (need of oxygen and/or intensive
care admission). Severe COVID-19 was associated with more advanced age (>= 65 years)
(odds ratio 3.72 [95% CI 1.79-7.71]). Only 60 patients (39.7%) with severe COVID-19
were receiving or had recent (<= 12 months) treatment for CLL at the time of COVID-19
versus 30/39 (76.9%) patients with mild disease. Hospitalization rate for severe COVID-19
was lower (p < 0.05) for patients on ibrutinib versus those on other regimens or off
treatment. Of 151 patients with severe disease, 55 (36.4%) succumbed versus only 1/38
(2.6%) with mild disease; age and comorbidities did not impact on mortality. In CLL,
(1) COVID-19 severity increases with age; (2) antileukemic treatment (particularly
BTK inhibitors) appears to exert a protective effect; (3) age and comorbidities did
not impact on mortality, alluding to a relevant role of CLL and immunodeficiency.
