Risk of severe COVID-19 outcomes for people affected by blood cancer.

In the global fight against COVID-19, researchers have made great progress in developing treatments to help reduce the virus's impact. However, people with blood cancer face unique and ongoing challenges when it comes to COVID-19. Our research aims to understand better how COVID-19 treatments are being used and their risks and benefits for this vulnerable group.
Our team at the University of Oxford has found that COVID-19 vaccines are safe and effective for adults with blood cancer, although their effectiveness decreases a few months after vaccination. We also discovered that while most adults with blood cancer received the first two vaccine doses, fewer people continued to get vaccinated after that. Additionally, vaccine uptake was lower among some ethnic groups and in more deprived areas, highlighting the need to better communicate the benefits of vaccination to these communities.
We now propose to extend our research to examine the uptake, safety, and effectiveness of COVID-19 treatments for people with blood cancer, including children and young people. This research will use more recent data, consider new COVID-19 variants and treatments, and look at the risks associated with different types of blood cancer.
Our objectives are:
1. To study how widely COVID-19 treatments are being used in people with blood cancer and without blood cancer
2. To assess how effective these treatments are in people with and without blood cancer
3. To evaluate the safety of these medications in people with and without blood cancer
By addressing these goals, we hope to fill important knowledge gaps and improve treatment strategies for people with blood cancer during the COVID-19 pandemic.

Read/SNOMED codes referring to the following:
Diagnoses of haematological malignancies (inc. leukaemia, lymphoma, myeloma, etc.).
Diagnoses of other blood disorders (sickle cell disease, sickle cell trait, aplastic anaemia)
Self-reported ethnicity (as per Office for National Statistics classification)
Geographical region in England (n=10) These are East Midlands, East of England, London, North East, North West, South Central, South East, South West, West Midlands, Yorkshire and Humber
Body mass index (BMI)
Townsend deprivation score
Prescriptions of immunosuppressant medications
Residential status (care home resident, lives in own home, homeless)

Co-morbidities included in QCOVID:
Cardiovascular diseases (atrial fibrillation, coronary heart disease, heart failure, congenital heart disease, peripheral vascular disease)
Respiratory diseases (asthma, chronic obstructive pulmonary disease, cystic fibrosis, bronchiectasis, pulmonary hypertension)
Diabetes diagnosis (any type 1 and type 2 diabetes)
Osteoporotic fracture of hip, spine, wrist or humerus
Chronic kidney diseases (stage 3-5)
Cirrhosis of liver
Neurological and psychiatric conditions (epilepsy, stroke/TIA, motor neurone disease, multiple sclerosis, myasthenia gravis, Huntington's disease, Parkinson's disease, dementia, cerebral palsy, learning disability, severe mental illness)
Immune and haematological conditions (rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, HIV/AIDS, thrombosis)
Lung or oral cancer
Bone marrow transplantation
Solid organ transplantation
Previous COVID-19 vaccination uptake


Potential complications of COVID-19 vaccination (venous thromboembolism, cerebral venous sinus thrombosis, anaphylaxis, immune thrombocytopenia, Guillain-Barre syndrome; these will be analysed separately)
Linkage to SACT (chemotherapy) database – chemotherapy use (drug/combination)

APC Date of admission and discharge & clinical codes relating to key outcomes

CC date of admission to critical care, clinical outcome, date of discharge

Positive SARS-CoV-2 rt-PCR tests (linkage to NHS Digital SGSS database; data on strain of SARS-CoV-2 if available, e.g. Delta variant)

COVID-19 vaccinations (type, number of doses, dates)

Deaths occurring during the study period (including causes thereof, primary and secondary [up to 13])

Recorded diagnoses of haematological malignancies, and other cancers of interest (used to define/restrict comparison groups for the analyses)

Haematological malignancies will be subdivided into leukaemias (e.g. ALL, AML, CML, CLL), lymphomas, and other relevant groups.