The Impact of COVID-19 on Leukemia Development and Manifestation: Analysis of Inflammatory Responses and Immune Dysregulation

Abstract

Introduction: COVID-19 may influence the development and manifestation of leukemias through inflammatory and immune dysregulation. SARS-CoV-2 infection triggers an intense inflammatory response and immune imbalance, factors that may impact the onset or progression of leukemias. Objective: To evaluate the association between COVID-19 and findings suggestive of neoplastically transformed leukocytes. Methods: A systematic review was conducted following the PRISMA guidelines, ensuring methodological rigor, transparency, and reproducibility. The search included the databases Medline, PubMed, SciELO, ScienceDirect, LILACS, Web of Science, and VHL (Virtual Health Library). Periods were analyzed: pre-pandemic (2019), pandemic (2020–2021), and post-pandemic (2022–2024). The main descriptors were malignant leukemias and post-COVID hematological malignancies. A total of 40 articles were selected based on thematic relevance, methodological quality, and current relevance, in addition to classic references for contextualization. Results: The analysis revealed recent findings that reinforce the interaction between systemic inflammation and clonal hematopoiesis. By inducing an exacerbated inflammatory response, COVID-19 alters hematopoiesis and favors the expansion of clones with mutations in genes such as DNMT3A and TET2, which may increase the risk of progression to hematologic neoplasms. Consistent reports of leukocyte atypia were identified in the blood counts of post-COVID-19 patients, suggesting an association with pre-existing clonal alterations. Conclusion: This systematic review demonstrates that SARS-CoV-2-induced hyperinflammation may be linked to the onset or worsening of leukemias, underscoring the importance of hematologic monitoring in post-COVID-19 patients.