Factors influencing survival and prolonged viral replication in patients with lymphoma and covid‐19: an observational cohort study from geltamo spanish group

Introduction: Lymphoma patients may be especially vulnerable to COVID-19, due to the immune dysregulation caused by the lymphoma itself and the antitumor treatments. Prolonged viral replication represents a major threat for both, patients and the public health. However, information about viral evolution is scarce. We aimed to describe the risk factors affecting survival and prolonged viral replication in patients with lymphoma after developing COVID-19. Methods: This is a retrospective multicenter study which included patients with a histological diagnosis of lymphoma and confirmed SARS-COV-2 infection before November 30, 2021. The primary outcome was overall survival (OS) 90 days after a COVID-19 diagnosis in hospitalized patients. The secondary outcome was prolonged viral replication, defined as patients with a prolonged positive real-time reverse transcription polymerase chain reaction at ≥3 weeks since diagnosis. For this analysis, we discarded all patients who died within the first 3 weeks of diagnosis. Results: A total of 399 patients (median age 67 [21–94] years, 56% male) from 32 centers were included; 164 patients had an indolent B-cell non-Hodgkin’s lymphoma (NHL), 129 aggressive B-cell NHL, 38 mantle-cell lymphoma, 29 peripheral T-cell lymphoma, and 29 Hodgkin’s lymphoma. 44.1% of patients were on active treatment at the time of COVID-19 diagnosis. 79% of patients were hospitalized, and 13% were admitted in the intensive care unit. With a median follow-up of 137 days (6–597), 118 patients have died (102 from COVID-19), with an estimated 90-day OS of 72% (95% CI 67%–76%) and 64% (95% CI 58%–69%) in the overall series and hospitalized patients, respectively. In the multivariate analysis, age ≥70 years (HR 2.85, 95% CI 2.17–4.72, p < 0.001), chronic heart disease (HR 1.80, 95% CI 1.11–2.91, p = 0.017), active lymphoma (HR 1.58, 95% CI 1.07–2.34, p = 0.022) and previous lines ≥3 (HR 1.76, 95% CI 1.08–2.87, p = 0.023) had independent influence on OS. Active antitumoral treatment and rituximab or obinutuzumab exposure in the last 6 months did not significantly impact OS (Figure 1). In contrast, active antitumoral treatment (12.9% vs. 7.1%, p = 0.073) and rituximab or obinutuzumab exposure in the last 6 months (15.2% vs. 4.6%, p = 0.001) were the single factors that increased the risk of prolonged viral replication, although only the last had significant influence in the multivariate analysis (RR 3.67, 95% CI 1.60–8.44, 0.002). Encore Abstract - previously submitted to regional or national meetings (up to <1’000 attendees) Keyword: Lymphoid Cancers - Other No conflicts of interests pertinent to the abstract.