TY - JOUR
T1 - Breakthrough COVID-19 in vaccinated patients with hematologic malignancies
T2 - results from the EPICOVIDEHA survey
AU - EPICOVIDEHA Survey members
AU - Pagano, Livio
AU - Salmanton-García, Jon
AU - Marchesi, Francesco
AU - Blennow, Ola
AU - Gomes da Silva, Maria
AU - Glenthøj, Andreas
AU - van Doesum, Jaap
AU - Bilgin, Yavuz M.
AU - López-García, Alberto
AU - Itri, Federico
AU - Nunes Rodrigues, Raquel
AU - Weinbergerová, Barbora
AU - Farina, Francesca
AU - Dragonetti, Giulia
AU - Berg Venemyr, Caroline
AU - van Praet, Jens
AU - Jaksic, Ozren
AU - Valković, Toni
AU - Falces-Romero, Iker
AU - Martín-Pérez, Sonia
AU - Jiménez, Moraima
AU - Dávila-Valls, Julio
AU - Schönlein, Martin
AU - Ammatuna, Emanuele
AU - Meers, Stef
AU - Delia, Mario
AU - Stojanoski, Zlate
AU - Nordlander, Anna
AU - Lahmer, Tobias
AU - Imre Pinczés, L. szló
AU - Buquicchio, Caterina
AU - Piukovics, Klára
AU - Ormazabal-Vélez, Irati
AU - Fracchiolla, Nicola
AU - Samarkos, Michail
AU - Méndez, Gustavo-Adolfo
AU - Hernández-Rivas, José-Ángel
AU - Espigado, Ildefonso
AU - Cernan, Martin
AU - Petzer, Verena
AU - Lamure, Sylvain
AU - di Blasi, Roberta
AU - Marques de Almedia, Joyce
AU - Dargenio, Michelina
AU - Biernat, Monika M.
AU - Sciumè, Mariarita
AU - de Ramón, Cristina
AU - de Jonge, Nick
AU - Batinić, Josip
AU - Aujayeb, Avinash
N1 - Funding Information: The authors thank Janina Leckler and all contributors for their utmost contributions and support to the project during a pandemic situation. EPICOVIDEHA has received funds from Optics COMMIT (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223). Contribution: L.P. served as the principal investigator; J.S.-G. and F.M. served as project manager and research assistant, respectively. L.P. J.S.-G. and F.M. contributed to study design, study supervision, and data interpretation and wrote the paper; A.B. P.C. M.H. P.K. A.P. F.P. O.A.C. and L.P. conceived the registry idea. L.P. J.S.-G. and F.M. did the statistical plan, analysis, and interpreted the data; all the authors recruited participants and collected and interpreted data; all authors contributed to manuscript writing and review of the manuscript; and all authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Funding Information: EPICOVIDEHA has received funds from Optics COMMIT (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223). Publisher Copyright: © 2022 The American Society of Hematology
PY - 2022/12/29
Y1 - 2022/12/29
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85142183130&partnerID=8YFLogxK
U2 - https://doi.org/10.1182/blood.2022017257
DO - https://doi.org/10.1182/blood.2022017257
M3 - Article
C2 - 36126318
SN - 0006-4971
VL - 140
SP - 2773
EP - 2787
JO - Blood
JF - Blood
IS - 26
ER -