Mortality and prognostic Factors in COVID-19 Patients with Hematologic Malignancies: A Retrospective Cohort Study in two Syrian centers

Abstract Background Patients with hematologic malignancies (HM) have poor outcomes from coronavirus disease (COVID-19), but data are limited, especially from low-income regions. This study analyzed mortality rates, clinical outcomes, and prognostic factors associated with COVID-19 infection in HM patients in Syria. Methods This retrospective cohort study enrolled 150 HM patients aged 16–78 years with confirmed COVID-19 at two hospitals in Damascus during 2021–2022. Patients were diagnosed based on RT-PCR or clinical/radiological findings with Chest computed tomography (CT) scans being the primary diagnostic modality. Data on demographics, cancer type, symptoms, comorbidities, CT findings, and outcomes were collected through medical records. Results The median age was 52.68 (± 18.49) years, with 64% of patients’ ≥50 years old. Acute lymphoblastic leukemia (18%) and acute myeloid leukemia (16.7%) were the most common HM types. The overall mortality rate was 61.4%. Mortality was significantly associated with older age (p = 0.001), cancer type (100% for acute leukemias, p = 0.001), Presence of dyspnea, cough, or digestive symptoms (p = 0.001), severe CT lung infiltrates (p = 0.001), and Pre-existing medical conditions (p = 0.001). Nearly, 37.3% of patients required ICU admission. All patients with non-Hodgkin's lymphoma survived, while all acute leukemia patients died. Conclusion Advanced age, specific cancer types, symptomatic presentation, CT severity, and presence comorbidities were identified as prognostic factors for COVID-19 mortality in HM patients. These high-risk patients warrant vigilant screening and preventive measures. Additional research is urgently needed to guide protection and clinical management in this vulnerable population.