COVID-19 Infection in patients with hemat ologic disorders in the Republic of Armenia: Four cases studies from the Nork National Center of Infectious Diseases
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COVID-19 Infection in patients with hemat ologic disorders in the Republic of Armenia: Four cases studies from the Nork National Center of Infectious Diseases Knarik Sargsyan
The COVID-19 pandemic presents unique challenges for immunocompromised patients. These patients include those with hematological malignancy such as acute and chronic leukemias, lymphomas, myelodysplastic syndromes, and multiple myeloma. Patients with malignancy disproportionately suffer from severe complications and fatality from COVID-19. These patients are at high risk of developing secondary bacterial and/or fungal infections.
Theoretically if treated with steroids during the first week of COVID-19 disease, worse clinical outcomes might be expected in immunocompromised patients. If so, the start of aggressive steroid treatment in the early stages of COVID-19 can prolong the course of disease and cause complications thus increasing the mortality rate.
We conducted a prospective observational study in all patients with COVID-19 diagnosis from the Nork National Center of Infectious Disease hospital between August 1st and November 30th, 2020. Four unique cases of SARS CoV-2 infection with hematological malignancies are described.
Based on analysis of the clinical course in these four patients we conclude that steroid therapy should not be casually administered in late stages of COVID-19. The choice of steroid, including dosage, duration, the initiation time and supportive therapy should be determined individually for each patient taking into account the course of the disease and the treatment received up to that point. In patients with immunosuppressed status, the risk of developing serious secondary infection is high. Receiving chemotherapy within the previous six months can significantly impact disease severity and outcomes. Further expanded investigations are needed to assess multiple factors impacting outcomes for patients with malignancy.
DOI: https://ysmu.am/v2/wp-content/uploads/2023/05/62e23384-1.pdf The New Armenian Medical Journal Vol.15 (2021), Nо 3 47-54
