Mortality by COVID-19 in adults with acute myeloid leukemia: a survey with hematologists in Brazil

Abstract

COVID-19 caused by the novel coronavirus SARS-COV-2 and frst detected in Wuhan, China in 2019, has become one of the worst pandemics in history [1, 2]. Although approximately 50% of the infected individuals are asymptomatic, some may develop severe cytokine release syndrome with intense immune response and endothelial damage [3]. Obesity, hypertension, diabetes, COPD, advanced age, and malignancy have been listed as risk factors for severe disease, hospitalization, admission in intensive care unit, and death [4, 5]. Patients with hematological malignancies also have a higher risk of severe events and among all of them, acute myeloid leukemia (AML) seems to have the highest risk for death by COVID-19 [6]. Because avoiding medical services visits or prolonged stays in hospital is not an option for AML patients, these individuals have a higher chance of getting in contact and being infected by SARS-COV-2. Once infected, these patients may be at high risk for severe complications and death as they have immunosuppression, neutropenia, and epithelial mucosal barrier damage [7]. AML afects individuals of all ages whom may be in diferent hematological scenarios such as in remission or with active disease that may be treated with intensive chemotherapy or low intensity treatment. The impact of COVID-19 in those diferent AML scenarios is unknown. Our aim is to report a survey conducted with Brazilian hematologists who attended AML patients with COVID-19, to evaluate the mortality rate seen by those doctors among their patients and any potential risk factor for death.