与血液病相关的 SARS-CoV-2 感染:撒哈拉以南非洲塞内加尔一家临床血液学中心的经验

IF 0.1 Q4 HEMATOLOGY Iraqi Journal of Hematology Pub Date : 2024-04-16 DOI:10.4103/ijh.ijh_3_24
Elhadji Daouda Niang, Serge Mwamba, K. Sarr, Soumaré Pape Maserigne, Ibrahima Gaye, Louis Fortes, Seynabou Fall, F. Ndiaye
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引用次数: 0

摘要

许多研究报告了 SARS-CoV-2 与良性和恶性血液病的关系。非洲系列的数据很少。这项研究在撒哈拉以南非洲进行,旨在研究与该感染相关的血液病的临床、生物学和进化特征。 这是一项历时 32 个月的回顾性横断面研究,包括 86 名良性或恶性血液病患者,他们都接受了冠状病毒病-2019(COVID-19)检查,并经实时逆转录酶聚合酶链反应证实,或出现与高度提示性计算机断层扫描(CT)体征相关的非典型临床体征。 患者的平均年龄为(48.3 ± 18.7)岁,性别比为 0.75。良性血液病主要有镰状细胞性状(SCT)(51 例)、镰状细胞病 SS(8 例)和镰状细胞病 SC(1 例),恶性血液病主要有多发性骨髓瘤(5 例)、非霍奇金淋巴瘤(5 例)和慢性淋巴细胞白血病(4 例)。临床症状主要表现为贫血综合征(16.3%),9.3%的同型镰状细胞患者出现血管闭塞危象。48%的病例为中度感染,19.7%为重度感染。重度感染常见于恶性血液病患者(47.6%),良性感染常见于良性血液病患者(38.4%)。全血细胞计数显示,32.5%的病例患有贫血,23.2%的病例患有淋巴细胞减少症。影像学方面,CT 扫描显示 41.3% 的病例有严重病变。76.7%的病例完全康复,23.3%的病例死亡。在单变量分析中,死亡主要发生在淋巴性血液病患者中(15%)。在单变量分析中,合并症(P < 0.0001)、淋巴性血液病(P < 0.0001)和 COVID-19 的严重程度(P < 0.0001)对死亡的发生有积极影响。 SARS-CoV-2 与血液病之间的关联并不罕见,而且以良性血液病为主。恶性血液病是一种高风险的基础疾病,因此有必要对轻型血液病进行住院随访,以提高存活率。必须特别关注有合并症的 SCT 和镰状细胞病患者。
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SARS-CoV-2 infection associated with hemopathies: An experience of a clinical hematology center in sub-Saharan Africa, Senegal
Many studies have reported the association of SARS-CoV-2 with benign and malignant hemopathies. Data from African series are scarce. This work was conducted in sub-Saharan Africa and aimed to study the clinical, biological, and evolutionary features of hemopathies associated with this infection. It was a retrospective, cross-sectional study carried out over 32 months including 86 patients with benign or malignant hemopathies who underwent coronavirus disease-2019 (COVID-19) confirmed by the real-time reverse transcriptase-polymerase chain reaction or presenting with atypical clinical signs associated with highly suggestive computed tomography (CT) scan signs. The mean age of patients was 48.3 ± 18.7 years with a sex ratio of 0.75. The main benign hemopathies were sickle cell trait (SCT) (n = 51), sickle cell disease SS (n = 8), and sickle cell disease SC (n = 1), while malignant hemopathies were represented by multiple myeloma (n = 5), non-Hodgkin lymphoma (n = 5), and chronic lymphocytic leukemia (n = 4). The clinical symptoms mainly featured anemic syndrome (16.3%) and a vaso-occlusive crisis was found in 9.3% of homozygous sickle-cell patients. The infection was moderate in 48% of cases and severe in 19.7%. The severe forms were commonly found in patients with malignant hemopathies (47.6%) and the benign forms were noted in benign hemopathies (38.4%). Full blood count outlined anemia in 32.5% and lymphopenia in 23.2% of cases. On imaging, the CT scan reported severe lesions in 41.3% of cases. The outcome resulted in full recovery in 76.7% of cases, and mortality occurred in 23.3%. In univariate analysis, death was mainly noted in patients with lymphoid hemopathies (15%). Comorbidities (P < 0.0001), lymphoid hemopathies (P < 0.0001), and the severity of COVID-19 (P < 0.0001) had a positive impact on death occurrence in univariate analysis. The association between SARS-CoV-2 and hemopathy is not uncommon and is dominated by benign hemopathies. Malignant hemopathies are at-risk underlying conditions justifying a hospital follow-up of mild forms, allowing better survival. Particular attention must be paid to SCT with comorbidities and those with sickle cell disease of disease.
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