Antic, DarkoDarkoAnticMilic, NatasaNatasaMilicChatzikonstantinou, ThomasThomasChatzikonstantinouScarfò, LydiaLydiaScarfòOtasevic, VladimirVladimirOtasevicRajovic, NinaNinaRajovicAllsup, DavidDavidAllsupAlonso Cabrero, AlejandroAlejandroAlonso CabreroAndres, MartinMartinAndresBaile Gonzales, MonicaMonicaBaile GonzalesCapasso, AntonellaAntonellaCapassoCollado, RosaRosaColladoCordoba, RaulRaulCordobaCuéllar-García, CarolinaCarolinaCuéllar-GarcíaCorrea, Juan GonzaloJuan GonzaloCorreaDe Paoli, LorenzoLorenzoDe PaoliDe Paolis, Maria RosariaMaria RosariaDe PaolisDel Poeta, GiovanniGiovanniDel PoetaDimou, MariaMariaDimouDoubek, MichaelMichaelDoubekEfstathopoulou, MariaMariaEfstathopoulouEl-Ashwah, ShaimaaShaimaaEl-AshwahEnrico, AliciaAliciaEnricoEspinet, BlancaBlancaEspinetFarina, LuciaLuciaFarinaFerrari, AngelaAngelaFerrariFoglietta, MyriamMyriamFogliettaLopez-Garcia, AlbertoAlbertoLopez-GarciaGarcía-Marco, José AJosé AGarcía-MarcoGarcía-Serra, RocíoRocíoGarcía-SerraGentile, MassimoMassimoGentileGimeno, EvaEvaGimenoda Silva, Maria GomesMaria Gomesda SilvaGutwein, OditOditGutweinHakobyan, Yervand KYervand KHakobyanHerishanu, YairYairHerishanuHernández-Rivas, José ÁngelJosé ÁngelHernández-RivasHerold, TobiasTobiasHeroldItchaki, GiladGiladItchakiJaksic, OzrenOzrenJaksicJanssens, AnnAnnJanssensKalashnikova, Olga BOlga BKalashnikovaKalicińska, ElżbietaElżbietaKalicińskaKater, Arnon PArnon PKaterKersting, SabinaSabinaKerstingKoren-Michowitz, MayaMayaKoren-MichowitzLabrador, JorgeJorgeLabradorLad, DeepeshDeepeshLadLaurenti, LucaLucaLaurentiFresa, AlbertoAlbertoFresaLevin, Mark-DavidMark-DavidLevinMayor Bastida, CarlotaCarlotaMayor BastidaMalerba, LaraLaraMalerbaMarasca, RobertoRobertoMarascaMarchetti, MoniaMoniaMarchettiMarquet, JuanJuanMarquetMihaljevic, BiljanaBiljanaMihaljevicMilosevic, IvanaIvanaMilosevicMirás, FatimaFatimaMirásMorawska, MartaMartaMorawskaMotta, MarinaMarinaMottaMunir, TalhaTalhaMunirMurru, RobertaRobertaMurruNunes, RaquelRaquelNunesOlivieri, JacopoJacopoOlivieriPavlovsky, Miguel ArturoMiguel ArturoPavlovskyPiskunova, IngaIngaPiskunovaPopov, Viola MariaViola MariaPopovQuaglia, Francesca MariaFrancesca MariaQuagliaQuaresmini, GiuliaGiuliaQuaresminiReda, GianluigiGianluigiRedaRigolin, Gian MatteoGian MatteoRigolinShrestha, AmitAmitShresthaŠimkovič, MartinMartinŠimkovičSmirnova, SvetlanaSvetlanaSmirnovaŠpaček, MartinMartinŠpačekSportoletti, PaoloPaoloSportolettiStanca, OanaOanaStancaStavroyianni, NikiNikiStavroyianniTe Raa, DoreenDoreenTe RaaTomic, KristinaKristinaTomicTonino, SanneSanneToninoTrentin, LivioLivioTrentinVan Der Spek, EllenEllenVan Der Spekvan Gelder, MichelMichelvan GelderVarettoni, MarziaMarziaVarettoniVisentin, AndreaAndreaVisentinVitale, CandidaCandidaVitaleVukovic, VojinVojinVukovicWasik-Szczepanek, EwaEwaWasik-SzczepanekWróbel, TomaszTomaszWróbelSegundo, Lucrecia Yáñez SanLucrecia Yáñez SanSegundoYassin, MohamedMohamedYassinCoscia, MartaMartaCosciaRambaldi, AlessandroAlessandroRambaldiMontserrat, EmiliEmiliMontserratFoà, RobinRobinFoàCuneo, AntonioAntonioCuneoCarrier, MarcMarcCarrierGhia, PaoloPaoloGhiaStamatopoulos, KostasKostasStamatopoulos2024-10-112024-10-112022-08-26https://boris-portal.unibe.ch/handle/20.500.12422/87077BACKGROUND Patients with chronic lymphocytic leukemia (CLL) may be more susceptible to COVID-19 related poor outcomes, including thrombosis and death, due to the advanced age, the presence of comorbidities, and the disease and treatment-related immune deficiency. The aim of this study was to assess the risk of thrombosis and bleeding in patients with CLL affected by severe COVID-19. METHODS This is a retrospective multicenter study conducted by ERIC, the European Research Initiative on CLL, including patients from 79 centers across 22 countries. Data collection was conducted between April and May 2021. The COVID-19 diagnosis was confirmed by the real-time polymerase chain reaction (RT-PCR) assay for SARS-CoV-2 on nasal or pharyngeal swabs. Severe cases of COVID-19 were defined by hospitalization and the need of oxygen or admission into ICU. Development and type of thrombotic events, presence and severity of bleeding complications were reported during treatment for COVID-19. Bleeding events were classified using ISTH definition. STROBE recommendations were used in order to enhance reporting. RESULTS A total of 793 patients from 79 centers were included in the study with 593 being hospitalized (74.8%). Among these, 511 were defined as having severe COVID: 162 were admitted to the ICU while 349 received oxygen supplementation outside the ICU. Most patients (90.5%) were receiving thromboprophylaxis. During COVID-19 treatment, 11.1% developed a thromboembolic event, while 5.0% experienced bleeding. Thrombosis developed in 21.6% of patients who were not receiving thromboprophylaxis, in contrast to 10.6% of patients who were on thromboprophylaxis. Bleeding episodes were more frequent in patients receiving intermediate/therapeutic versus prophylactic doses of low-molecular-weight heparin (LWMH) (8.1% vs. 3.8%, respectively) and in elderly. In multivariate analysis, peak D-dimer level and C-reactive protein to albumin ratio were poor prognostic factors for thrombosis occurrence (OR = 1.022, 95%CI 1.007‒1.038 and OR = 1.025, 95%CI 1.001‒1.051, respectively), while thromboprophylaxis use was protective (OR = 0.199, 95%CI 0.061‒0.645). Age and LMWH intermediate/therapeutic dose administration were prognostic factors in multivariate model for bleeding (OR = 1.062, 95%CI 1.017-1.109 and OR = 2.438, 95%CI 1.023-5.813, respectively). CONCLUSIONS Patients with CLL affected by severe COVID-19 are at a high risk of thrombosis if thromboprophylaxis is not used, but also at increased risk of bleeding under the LMWH intermediate/therapeutic dose administration.enAge Anticoagulation therapy Bleeding CLL COVID-19 D-dimer LMWH Thromboprophylaxis Thrombosis600 - Technology::610 - Medicine & healtharticle10.48350/1724443602885710.1186/s13045-022-01333-0