Year: 2022
Type: Article
Title: Breakthrough COVID-19 in vaccinated patients with hematologic malignancies: results from EPICOVIDEHA survey
Author: Pagano, Livio
Author: Salmanton-García, Jon
Author: Marchesi, Francesco
Author: Blennow, Ola
Author: Gomes da Silva, Maria
Author: Glenthøj, Andreas
Author: van Doesum, Jaap A
Author: Bilgin, Yavuz M
Author: Lopez-Garcia, Alberto
Author: Itri, Federico
Author: Nunes Rodrigues, Raquel
Author: Weinbergerová, Barbora
Author: Farina, Francesca
Author: Dragonetti, Giulia
Author: Berg Venemyr, Caroline
Author: Van Praet, Jens
Author: Jaksic, Ozren
Author: Valkovic, Toni
Author: Falces-Romero, Iker
Author: Martin-Perez, Sonia
Author: Jiménez, Moraima
Author: Davila-Valls, Julio
Author: Schonlein, Martin
Author: Ammatuna, Emanuele
Author: Meers, Stef
Author: Delia, Mario
Author: Stojanoski, Zlate
Author: Nordlander, Anna
Author: Lahmer, Tobias
Author: Pinczés, László Imre
Author: Buquicchio, Caterina
Author: Piukovics, Klára
Author: Ormazabal-Velez, Irati
Author: Fracchiolla, Nicola Stefano
Author: Samarkos, Michail
Author: Mendez, Gustavo-Adolfo
Author: Hernández-Rivas, José-Ángel
Author: Espigado, Ildefonso
Author: Cernan, Martin
Author: Petzer, Verena
Author: Lamure, Sylvain
Author: Di Blasi, Roberta
Author: Marques de Almeida, Joyce
Author: Dargenio, Michelina
Author: Biernat, Monika Maria
Author: Sciumè, Mariarita
Author: de Ramón, Cristina
Author: De Jonge, Nick Alexander
Author: Batinic, Josip
Author: Aujayeb, Avinash
Author: Marchetti, Monia
Author: Fouquet, Guillemette
Author: Fernández Escalada, Noemi
Author: Zambrotta, Giovanni Paolo Maria
Author: Sacchi, Maria Vittoria
Author: Guidetti, Anna
Author: Demirken, Fatih
Author: Prezioso, Lucia
Author: Racil, Zdenek
Author: Nucci, Marcio
Author: Mladenovic, Miloš
Author: Lievin, Raphaël
Author: Hanakova, Michaela
Author: Grafe, Stefanie K
Author: Sili, Uluhan
Author: Machado, Marina
Author: Cattaneo, Chiara
Author: Adzic-Vukicevic, Tatjana
Author: Verga, Luisa
Author: Labrador, Jorge
Author: Rahimli, Laman
Author: Bonanni, Matteo
Author: Passamonti, Francesco
Author: Pagliuca, Antonio
Author: Corradini, Paolo
Author: Hoenigl, Martin
Author: Koehler, Philipp
Author: Busca, Alessandro
Author: Cornely, Oliver A
Abstract: Limited data have been published on the epidemiology and outcomes of breakthrough COVID-19 in patients with hematological malignancy (HM) after anti-SARS-CoV-2 vaccination. Adult HM who received at least one dose of anti-SARS-CoV-2 vaccine and diagnosed with breakthrough COVID-19 between January 2021 and March 2022 and registered in EPICOVIDEHA were included in this analysis. A total of 1548 cases were included, mainly with lymphoid malignancies (1181 cases, 76%). After viral genome sequencing in 753 cases (49%), Omicron variant was prevalent (517, 68.7%). Most of the patients received at least two vaccine doses before COVID-19 (1419, 91%), mostly mRNA-based (1377, 89%). Overall, 906 patients (59%) received specific treatment for COVID-19. After 30-days follow-up from COVID-19 diagnosis, 143 patients (9%) died. The mortality rate in patients with Omicron variant was of 7.9%, comparable to that reported for the other variants. The 30-day mortality rate was significantly lower than in the pre-vaccine era (31%). In the univariable analysis, older age (p<0.001), active HM (p<0.001), severe and critical COVID-19 (p=0.007 and p<0.001, respectively) were associated with mortality. Conversely, patients receiving monoclonal antibodies, even for severe or critical COVID-19, had a lower mortality rate (p<0.001). In the multivariable model, older age, active disease, critical COVID-19 and at least 2-3 comorbidities were correlated with a higher mortality, whereas the administration of monoclonal antibodies, alone (p<0.001) or combined with antivirals (p=0.009), was observed protective. While mortality is significantly lower than in the pre-vaccination era, breakthrough COVID-19 in HM is still associated with considerable mortality. Death rate was lower in patients who received monoclonal antibodies, alone or in combination with antivirals. EPICOVIDEHA (www.clinicaltrials.gov; National Clinical Trials identifier NCT04733729) is an international open web-based registry for patients with HMs infected with SARS-CoV-2.
Publisher: American Society of Hematology
Relation: Blood
Identifier: oai:repository.ukim.mk:20.500.12188/23696
Identifier: http://hdl.handle.net/20.500.12188/23696Identifier: 10.1182/blood.2022017257
Identifier: https://ashpublications.org/blood/article-pdf/doi/10.1182/blood.2022017257/1922289/blood.2022017257.pdfIdentifier: https://ashpublications.org/blood/article-pdf/doi/10.1182/blood.2022017257/1922289/blood.2022017257.pdf
