Practical management of patients with hematological diseases during the COVID-19 pandemic in Japan

• Published in: International journal of hematology Vol. 114; no. 6; pp. 709 - 718
• Main Authors: Hagihara, Masao, Ohara, Shin, Uchida, Tomoyuki, Inoue, Morihiro
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.12.2021; Springer Nature B.V
• Subjects: Antibodies; Antibodies, Viral - blood; Biomarkers - blood; Chemotherapy; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - diagnosis; COVID-19 - mortality; COVID-19 - prevention & control; Cross Infection - prevention & control; Female; Hematologic Diseases - complications; Hematologic Diseases - mortality; Hematologic Diseases - therapy; Hematological diseases; Hematology; Humans; Idiopathic thrombocytopenic purpura; Immunoassay - methods; Immunoglobulin G; Immunoglobulin G - blood; Infection Control - methods; Infections; Japan; Lymphoma; Male; Medicine; Medicine & Public Health; Myeloma; Oncology; Original; Original Article; Pandemics; Patient Isolation; Polymerase Chain Reaction; Prednisolone; Remission; Respiratory failure; Risk; SARS-CoV-2 - immunology; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; Survival Rate; Viral diseases; Viruses; Japan; COVID-19; Nosocomial infection; Anti-SARS-CoV-2 IgG; Survival
• ISSN: 0925-5710; 1865-3774; 1865-3774
• DOI: 10.1007/s12185-021-03175-x

Polymerase chain reaction (PCR) tests cannot always detect the SARS-CoV-2 virus, possibly due to differences in sensitivity between sample types. Under these circumstances, immunochromatography may serve as an alternative method to detect anti-SARS-CoV-2 IgG antibodies that indicate a history of infection. In our analysis of patients with severe COVID-19 infection, we found that 14 of 19 serum samples were positive for IgG antibodies, whereas 6 of 10 samples from patients with asymptomatic or mild cases were negative. Two patients with immune thrombocytopenia who were treated with prednisolone experienced aggressive COVID-19-related respiratory failure and eventually died. Patients not in remission and those who received steroid-based chemotherapy had a higher risk of death, and patients with lymphoid malignancies including lymphoma and myeloma died in larger numbers than those with myeloid malignancies. A stricter cohorting strategy based on repeat PCR tests or isolation to a private room should be adopted in routine care in hematology departments to prevent viral spread to the environment.