Publication details

Breakthrough COVID-19 in vaccinated patients with hematologic malignancies: results from the EPICOVIDEHA survey

Authors

PAGANO Livio SALMANTON-GARCIA Jon MARCHESI Francesco BLENNOW Ola GOMES da Silva Maria GLENTHOJ Andreas JAAP van Doesum BILGIN Yavuz M LOPEZ-GARCIA Alberto ITRI Federico RODRIGUES Raquel Nunes WEINBERGEROVA Barbora FARINA Francesca DRAGONETTI Giulia VENEMYR Caroline Berg JENS van Praet JAKSIC Ozren VALKOVIC Toni FALCES-ROMERO Iker MARTIN-PEREZ Sonia JIMENEZ Moraima DAVILA-VALLS Julio SCHONLEIN Martin AMMATUNA Emanuele MEERS Stef DELIA Mario STOJANOSKI Zlate NORDLANDER Anna LAHMER Tobias PINCZES Laszlo Imre BUQUICCHIO Caterina PIUKOVICS Klara ORMAZABAL-VELEZ Irati FRACCHIOLLA Nicola SAMARKOS Michail MENDEZ Gustavo-Adolfo HERNANDEZ-RIVAS Jose-Angel ESPIGADO Ildefonso CERNAN Martin PETZER Verena LAMURE Sylvain ROBERTA di Blasi MARQUES de Almedia Joyce DARGENIO Michelina BIERNAT Monika M SCIUME Mariarita CRISTINA de Ramon NICK de Jonge BATINIC Josip AUJAYEB Avinash MARCHETTI Monia FOUQUET Guillemette FERNANDEZ Noemi ZAMBROTTA Giovanni SACCHI Maria Vittoria GUIDETTI Anna DEMIRKAN Fatih PREZIOSO Lucia RÁČIL Zdeněk NUCCI Marcio MLADENOVIC Milos LIEVIN Raphael HANAKOVA Michaela GRAFE Stefanie SILI Uluhan MACHADO Marina CATTANEO Chiara ADZIC-VUKICEVIC Tatjana VERGA Luisa LABRADOR Jorge RAHIMLI Laman BONANNI Matteo PASSAMONTI Francesco PAGLIUCA Antonio CORRADINI Paolo HOENIGL Martin KOEHLER Philipp BUSCA Alessandro CORNELY Oliver A

Year of publication 2022
Type Article in Periodical
Magazine / Source Blood
MU Faculty or unit

Faculty of Medicine

Citation
Web https://ashpublications.org/blood/article/140/26/2773/486672/Breakthrough-COVID-19-in-vaccinated-patients-with
Doi http://dx.doi.org/10.1182/blood.2022017257
Keywords COVID-19; patients with hematologic malignancies
Description Limited data are available on breakthrough COVID-19 in patients with hematologic malignancy (HM) after anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) 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 mRNAbased (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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