Breakthrough COVID-19 in vaccinated patients with hematologic malignancies: results from the EPICOVIDEHA survey (CROSBI ID 322977)
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Pagano, Livio ; Salmanton-García, Jon ; Marchesi, Francesco ; Blennow, Ola ; Gomes da Silva, Maria ; Glenthøj, Andreas ; van Doesum, Jaap ; Bilgin, Yavuz M. ; López-García, Alberto ; Itri, Federico ; Nunes Rodrigues, Raquel ; Weinbergerová, Barbora ; Farina, Francesca ; Dragonetti, Giulia ; Berg Venemyr, Caroline ; van Praet, Jens ; Jakšić, Ozren ; Valković, Toni ; Falces-Romero, Iker ; Martín-Pérez, Sonia ; Jiménez, Moraima ; Dávila- Valls, Julio ; Schönlein, Martin ; Ammatuna, Emanuele ; Meers, Stef ; Delia, Mario ; Stojanoski, Zlate ; Nordlander, Anna ; Lahmer, Tobias ; Imre Pinczés, László ; Buquicchio, Caterina ; Piukovics, Klára ; Ormazabal-Vélez, Irati ; Fracchiolla, Nicola ; Samarkos, Michail ; Méndez, Gustavo-Adolfo ; Hernández-Rivas, José- Ángel ; Espigado, Ildefonso ; Cernan, Martin ; Petzer, Verena ; Lamure, Sylvain ; di Blasi, Roberta ; Marques de Almedia, Joyce ; Dargenio, Michelina ; Biernat, Monika M. ; Sciumè, Mariarita ; de Ramón, Cristina ; de Jonge, Nick ; Batinić, Josip ; Aujayeb, Avinash ; Marchetti, Monia ; Fouquet, Guillemette ; Fernández, Noemí ; Zambrotta, Giovanni ; Sacchi, Maria Vittoria ; Guidetti, Anna ; Demirkan, Fatih ; Prezioso, Lucia ; Ráčil, Zdeněk ; Nucci, Marcio ; Mladenović, Miloš ; Liévin, Raphaël ; Hanáková, Michaela ; Gräfe, Stefanie ; Sili, Uluhan ; Machado, Marina ; Cattaneo, Chiara ; Adžić- Vukičević, Tatjana ; Verga, Luisa ; Labrador, Jorge ; Rahimli, Laman ; Bonanni, Matteo ; Passamonti, Francesco ; Pagliuca, Antonio ; Corradini, Paolo ; Hoenigl, Martin ; Koehler, Philipp ; Busca, Alessandro ; Cornely, Oliver A.
engleski
Breakthrough COVID-19 in vaccinated patients with hematologic malignancies: results from the EPICOVIDEHA survey
Limited data are available on breakthrough COVID- 19 in patients with hematologic malignancy (HM) after anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. Adult patients with HM, ≥1 dose of anti-SARS-CoV-2 vaccine, and breakthrough COVID-19 between January 2021 and March 2022 were analyzed. A total of 1548 cases were included, mainly lymphoid malignancies (1181 cases, 76%). After viral sequencing in 753 cases (49%), the Omicron variant was prevalent (517, 68.7%). Most of the patients received ≤2 vaccine doses before COVID-19 (1419, 91%), mostly mRNA-based (1377, 89%). Overall, 906 patients (59%) received COVID-19-specific treatment. After 30-day follow-up from COVID-19 diagnosis, 143 patients (9%) died. The mortality rate in patients with the Omicron variant was 7.9%, comparable to other variants, with a significantly lower 30-day mortality rate than in the prevaccine era (31%). In the univariable analysis, older age (P < .001), active HM (P < .001), and severe and critical COVID- 19 (P = .007 and P < .001, respectively) were associated with mortality. Conversely, patients receiving monoclonal antibodies, even for severe or critical COVID-19, had a lower mortality rate (P < .001). In the multivariable model, older age, active disease, critical COVID-19, and 2-3 comorbidities were correlated with a higher mortality, whereas monoclonal antibody administration, alone (P < .001) or combined with antivirals (P = .009), was protective. Although mortality is significantly lower than in the prevaccination 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.
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