INTRODUCTION Patients with cancer may be more susceptible to and have higher morbidity and mortality rates from COVID-19 than the general population, while epidemiologic data specifically addressed to hematologic patients are limited . To investigate whether patients with hematologic diseases undergoing therapy are at increased risk for acquiring SARS CoV-2 infection compared to the general population, a retrospective study was carried out at a referral hematologic center in Rome, Italy, during the period of the greatest epidemic spread (March 8 to May 14 , 2020).
METHODS All adult and pediatric patients with a diagnosis of a neoplastic or a nonneoplastic hematologic disease who underwent treatment (chemotherapy or immunosuppressive or supportive therapy) during the study period or in the previous 6 months were considered . The prevalence of COVID-19 in the overall outpatient and inpatient population undergoing hematologic treatment compared to that of the general population was analyzed . The measures taken to manage patients during the epidemic period are described .
RESULTS Overall, 2,513 patients with hematological diseases were considered . Out of 243 (9.7 %) patients who were screened for SARS CoV-2, three of 119 (2.5 %) outpatients with fever or respiratory symptoms and none of 124 asymptomatic patients were diagnosed with COVID-19 . Three further patients were diagnosed with COVID-19 and managed in other hospitals in Rome . As of May 14 , 2020, the prevalence of COVID-19 in our hematologic population accounted for 0.24% (95% CI 0.23-0.25; 6 of 2,513 patients : 1 case in every 419 patients) as compared to 0.12% (7,280 of 5,879,082 residents; 1 case in every 807 residents) in the general population (p = 0.14). Three of 6 patients diagnosed with COVID-19 required critical care and 2 died while still positive for SARS CoV-2 . Out of 225 healthcare providers on duty at our Institution during the study period , 2 (0.9 %) symptomatic cases were diagnosed with COVID-19 .
CONCLUSION In our experience, the prevalence of COVID-19 in hematologic patients, mainly affected by malignancies, was not significantly higher compared to that of the general population . Definition of adapted strategies for healthcare services, while continuing to administer the standard hematologic treatments, represents the crucial challenge for the management of hematologic diseases in the COVID-19 era.