COVID-19 severity and mortality in patients with chronic lymphocytic leukemia: a joint study by ERIC, the European Research Initiative on CLL, and CLL Campus

Lydia Scarfò, Thomas Chatzikonstantinou, Gian Matteo Rigolin, Giulia Quaresmini, Marina Motta, Candida Vitale, Jose Antonio Garcia-Marco, José Ángel Hernández-Rivas, Fatima Mirás, Mónica Baile, Juan Marquet, Carsten U. Niemann, Gianluigi Reda, Talha Munir, Eva Gimeno, Monia Marchetti, Francesca Maria Quaglia, Marzia Varettoni, Julio Delgado, Sunil IyengarAnn Janssens, Roberto Marasca, Angela Ferrari, Carolina Cuéllar-García, Gilad Itchaki, Martin Špaček, Lorenzo De Paoli, Luca Laurenti, Mark David Levin, Enrico Lista, Francesca R. Mauro, Martin Šimkovič, Ellen Van Der Spek, Elisabeth Vandenberghe, Livio Trentin, Ewa Wasik-Szczepanek, Rosa Ruchlemer, Dominique Bron, Maria Rosaria De Paolis, Giovanni Del Poeta, Lucia Farina, Myriam Foglietta, Massimo Gentile, Yair Herishanu, Tobias Herold, Ozren Jaksic, Arnon P. Kater, Sabina Kersting, Lara Malerba, Lorella Orsucci, Viola Maria Popov, Paolo Sportoletti, Mohamed Yassin, Barbara Pocali, Gabor Barna, Annalisa Chiarenza, Gimena dos Santos, Eugene Nikitin, Martin Andres, Maria Dimou, Michael Doubek, Alicia Enrico, Yervand Hakobyan, Olga Kalashnikova, Macarena Ortiz Pareja, Maria Papaioannou, Davide Rossi, Nimish Shah, Amit Shrestha, Oana Stanca, Niki Stavroyianni, Vladimir Strugov, Constantine Tam, Mihnea Zdrenghea, Marta Coscia, Kostas Stamatopoulos*, Giuseppe Rossi, Alessandro Rambaldi, Emili’ Montserrat, Robin Foà, Antonio Cuneo, Paolo Ghia*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Chronic lymphocytic leukemia (CLL) is a disease of the elderly, characterized by immunodeficiency. Hence, patients with CLL might be considered more susceptible to severe complications from COVID-19. We undertook this retrospective international multicenter study to characterize the course of COVID-19 in patients with CLL and identify potential predictors of outcome. Of 190 patients with CLL and confirmed COVID-19 diagnosed between 28/03/2020 and 22/05/2020, 151 (79%) presented with severe COVID-19 (need of oxygen and/or intensive care admission). Severe COVID-19 was associated with more advanced age (≥65 years) (odds ratio 3.72 [95% CI 1.79–7.71]). Only 60 patients (39.7%) with severe COVID-19 were receiving or had recent (≤12 months) treatment for CLL at the time of COVID-19 versus 30/39 (76.9%) patients with mild disease. Hospitalization rate for severe COVID-19 was lower (p < 0.05) for patients on ibrutinib versus those on other regimens or off treatment. Of 151 patients with severe disease, 55 (36.4%) succumbed versus only 1/38 (2.6%) with mild disease; age and comorbidities did not impact on mortality. In CLL, (1) COVID-19 severity increases with age; (2) antileukemic treatment (particularly BTK inhibitors) appears to exert a protective effect; (3) age and comorbidities did not impact on mortality, alluding to a relevant role of CLL and immunodeficiency.

Original languageEnglish
Pages (from-to)2354-2363
Number of pages10
Issue number9
StatePublished - 1 Sep 2020


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