Hematologic neoplasms as a risk factor for severe COVID-19: systematic review and meta-analysis

• Grant number: 22/04612-0
• Support Opportunities: Regular Research Grants
• Duration: September 01, 2022 - August 31, 2025
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Paula de Oliveira Montandon Hokama
• Grantee: Paula de Oliveira Montandon Hokama
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil
• Associated researchers: Newton Key Hokama ; Vania dos Santos Nunes Nogueira

Abstract

Patients with hematological malignancy have compromised immunity due to the malignancy of the disease and/or treatment, leading to a high risk for severe COVID-19. However, most of the scientific studies available gather patients with hematological malignancies and solid tumors in a single group, making no distinction as to the different types of hematological tumors and their treatments. Objective: This systematic review aims to explore the risk of severe COVID-19 in patients with hematologic malignancy. Studies on patients, adults or children, with hematologic malignancy and COVID-19 will be included. Methodology: A systematic review will be performed according to the Joanna Briggs Institute methodology for systematic reviews of etiology and risk. The review will consider as participants, adults or children with COVID-19 infection detected by RT-PCR or serology for SARS-CoV-2. Studies without routine laboratory confirmation of COVID-19 will be included if patients have clinical/physical examination and CT scan suggestive of COVID-19. The exhibit of interest will be hematologic malignancy, which includes lymphomas (Hodgkin's and non-Hodgkin's), acute and chronic leukemias, multiple myeloma, myelodysplastic syndrome, and myeloproliferative diseases. Cross-sectional, cohort and case-control analytical studies will be considered. Outcomes among COVID-19 patients are critical symptoms, hospitalizations, intensive care unit admissions, mechanical ventilation, and deaths. We will exclude studies with neoplasms other than hematological ones. Search strategies were created for Embase, Medline and LILACS. Two reviewers will independently assess studies for eligibility, extract data, and assess their risk of bias. Similar results measured in at least two studies will be plotted in the meta-analysis using the JBI System for Unified Management, Assessment and Review of Information (JBI SUMARI). Preliminary Discussion: This systematic review aims to assess whether patients with hematologic malignancy are at increased risk of severe COVID-19. This review will differ from previous ones by including controlled studies and groups with hematologic malignancy only, excluding other cancers. The main hypothesis of our research is that not all patients with hematologic cancer are at high risk of severe COVID-19. PROSPERO: CRD42020199318. (AU)