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Liu Y, Fa H. High-dose dual-antibiotic loaded cement for hip hemiarthroplasty. Lancet 2024; 403:1853. [PMID: 38734471 DOI: 10.1016/s0140-6736(24)00481-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 03/06/2024] [Indexed: 05/13/2024]
Affiliation(s)
- Yang Liu
- The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China.
| | - Hua Fa
- The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China
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2
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Zhu H, Lu X, Zhang X, Hua H, Zhang J, Miao Y, Gu W, Xu M, Lu X, Li B, Wang C, Ni H, Qian J, Shi J, Xu M, Wu G, Zhang Y, Shen Q, Wang Z, Zhu J, Cheng Z, Zhuang W, Lin G, Hu Y, Shan Q, Chen Y, Qiu H, Li J, Shi W. Multi-center study of COVID-19 infection in elderly patients with lymphoma: on behalf of Jiangsu Cooperative Lymphoma Group (JCLG). Ann Hematol 2024:10.1007/s00277-024-05744-6. [PMID: 38649594 DOI: 10.1007/s00277-024-05744-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
Elderly patients with lymphoproliferative diseases (LPD) are vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Here, we retrospectively described the clinical features and outcomes of the first time infection of Omicron SARS-CoV-2 in 364 elderly patients with lymphoma enrolled in Jiangsu Cooperative Lymphoma Group (JCLG) between November 2022 and April 2023 in China. Median age was 69 years (range 60-92). 54.4% (198/364) of patients were confirmed as severe and critical COVID-19 infection. In univariable analysis, Age > 70 years (OR 1.88, p = 0.003), with multiple comorbidities (OR 1.41, p = 0.005), aggressive lymphoma (OR 2.33, p < 0.001), active disease (progressive or relapsed/refractory, OR 2.02, p < 0.001), and active anti-lymphoma therapy (OR 1.90, p < 0.001) were associated with severe COVID-19. Multiple (three or more) lines of previous anti-lymphoma therapy (OR 3.84, p = 0.021) remained an adverse factor for severe COVID-19 in multivariable analysis. Moreover, CD20 antibody (Rituximab or Obinutuzumab)-based treatments within the last 6 months was associated with severe COVID-19 in the entire cohort (OR 3.42, p < 0.001). Continuous BTK inhibitors might be protective effect on the outcome of COVID-19 infection (OR 0.44, p = 0.043) in the indolent lymphoma cohort. Overall, 7.7% (28/364) of the patients ceased, multiple lines of previous anti-lymphoma therapy (OR 3.46, p = 0.016) remained an adverse factor for mortality.
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Affiliation(s)
- Huayuan Zhu
- Department of Hematology, Lymphoma Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China.
| | - Xiao Lu
- Department of Hematology, Lymphoma Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Xiaoping Zhang
- Department of Hematology, The Affiliated Zhongda Hospital of Southeast University Medical College, Nanjing, 210044, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Haiying Hua
- Department of Hematology, Wuxi Third People's Hospital, Wuxi, 214045, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Jie Zhang
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, 226001, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Yuqing Miao
- Department of Hematology, Yancheng First People's Hospital, Yancheng, 224006, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Weiying Gu
- Department of Hematology, The First People's Hospital of Changzhou and The Third Affiliated Hospital of Soochow University, Changzhou, 213004, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Min Xu
- Department of Hematology, Zhangjiagang First Affiliated Hospital of Soochow University, Zhangjiagang, 215699, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Xuzhang Lu
- Department of Hematology, Affiliated Changzhou Second Hospital of Nanjing Medical University, Changzhou, 213004, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Bingzong Li
- Department of Hematology, the Second Affiliated Hospital of Soochow University, Suzhou, 215004, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Chunling Wang
- Department of Hematology, The First People's Hospital of Huai'an, Huai'an, 223399, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Haiwen Ni
- Department of Hematology, The Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing, 210004, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Jun Qian
- Department of Hematology, Affiliated People's Hospital of Jiangsu University, Zhenjiang, 212002, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Jinning Shi
- Department of Hematology, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, 211199, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Maozhong Xu
- Department of Hematology, The Affiliated Jiangyin Hospital of Southeast University Medical College, Jiangyin, 214433, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Guangqi Wu
- Department of Hematology, The First People's Hospital of Suqian, Suqian, 223812, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Yunping Zhang
- Department of Hematology, The Affiliated Yixing Hospital of Jiangsu University, Yixing, 214206, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Qiudan Shen
- Department of Hematology, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215008, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Zhi Wang
- Department of Hematology, Wuxi Second People's Hospital, Wuxi, 214001, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Jianfeng Zhu
- Department of Hematology, The People's Hospital of Taizhou, Taizhou, 225399, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Zhen Cheng
- Department of Hematology, Taicang Hospital Affiliated to Soochow University, Taicang, 215488, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Wanchuan Zhuang
- Department of Hematology, The Second People's Hospital of Lianyungang, Lianyungang, 222002, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Guoqiang Lin
- Department of Hematology, Huai'an Hospital Affiliated to Xuzhou Medical College and Huai'an Second People's Hospital, Huai'an, 223022, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Yongjun Hu
- Department of Hematology, Huaiyin Hospital of Huai'an, Huai'an, 223399, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Qiurong Shan
- Department of Hematology, Shuyang Traditional Chinese Medicine Hospital, Shuyang, 223614, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Yifei Chen
- Department of Hematology, Jiangdu People's Hospital of Yangzhou, Yangzhou, 225202, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Hongchun Qiu
- Department of Hematology, The Third People's Hospital of Kunshan, Kunshan, 215316, China
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China
| | - Jianyong Li
- Department of Hematology, Lymphoma Center, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China.
| | - Wenyu Shi
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, 226001, China.
- Department of Hematology, Affiliated Hospital of Nantong University, 20 Xisi Road, Nantong, 226001, Jiangsu, China.
- Jiangsu Cooperative Lymphoma Group (JCLG), Nanjing, China.
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Salmanton-García J, Marchesi F, Koehler P, Weinbergerová B, Čolović N, Falces-Romero I, Buquicchio C, Farina F, van Praet J, Biernat MM, Itri F, Prezioso L, Tascini C, Vena A, Romano A, Delia M, Dávila-Valls J, Martín-Pérez S, Lavilla-Rubira E, Adžić-Vukičević T, García-Bordallo D, López-García A, Criscuolo M, Petzer V, Fracchiolla NS, Espigado I, Sili U, Meers S, Erben N, Cattaneo C, Tragiannidis A, Gavriilaki E, Schönlein M, Mitrovic M, Pantic N, Merelli M, Labrador J, Hernández-Rivas JÁ, Glenthøj A, Fouquet G, Del Principe MI, Dargenio M, Calbacho M, Besson C, Kohn M, Gräfe S, Hersby DS, Arellano E, Çolak GM, Wolf D, Marchetti M, Nordlander A, Blennow O, Cordoba R, Mišković B, Mladenović M, Bavastro M, Limongelli A, Rahimli L, Pagano L, Cornely OA. Molnupiravir compared to nirmatrelvir/ritonavir for COVID-19 in high-risk patients with haematological malignancy in Europe. A matched-paired analysis from the EPICOVIDEHA registry. Int J Antimicrob Agents 2023; 62:106952. [PMID: 37582478 DOI: 10.1016/j.ijantimicag.2023.106952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/24/2023] [Accepted: 08/05/2023] [Indexed: 08/17/2023]
Abstract
INTRODUCTION Molnupiravir and nirmatrelvir/ritonavir are antivirals used to prevent progression to severe SARS-CoV-2 infections and decrease hospitalisation and mortality rates. Nirmatrelvir/ritonavir was authorised in Europe in December 2021, whereas molnupiravir is not yet licensed in Europe as of February 2022. Molnupiravir may be an alternative to nirmatrelvir/ritonavir because it is associated with fewer drug-drug interactions and contraindications. A caveat for molnupiravir is the mode of action induces viral mutations. Mortality rate reduction with molnupiravir was less pronounced than that with nirmatrelvir/ritonavir in patients without haematological malignancy. Little is known about the comparative efficacy of the two drugs in patients with haematological malignancy at high-risk of severe COVID-19. Thus, molnupiravir and nirmatrelvir/ritonavir were compared in a cohort of patients with haematological malignancies. METHODS Clinical data from patients treated with molnupiravir or nirmatrelvir/ritonavir monotherapy for COVID-19 were retrieved from the EPICOVIDEHA registry. Patients treated with molnupiravir were matched by sex, age (±10 years), and severity of baseline haematological malignancy to controls treated with nirmatrelvir/ritonavir. RESULTS A total of 116 patients receiving molnupiravir for the clinical management of COVID-19 were matched to an equal number of controls receiving nirmatrelvir/ritonavir. In each of the groups, 68 (59%) patients were male; with a median age of 64 years (interquartile range [IQR] 53-74) for molnupiravir recipients and 64 years (IQR 54-73) for nirmatrelvir/ritonavir recipients; 56.9% (n=66) of the patients had controlled baseline haematological malignancy, 12.9% (n=15) had stable disease, and 30.2% (n=35) had active disease at COVID-19 onset in each group. During COVID-19 infection, one third of patients from each group were admitted to hospital. Although a similar proportion of patients in the two groups were vaccinated (molnupiravir n=77, 66% vs. nirmatrelvir/ritonavir n=87, 75%), more of those treated with nirmatrelvir/ritonavir had received four vaccine doses (n=27, 23%) compared with those treated with molnupiravir (n=5, 4%) (P<0.001). No differences were detected in COVID-19 severity (P=0.39) or hospitalisation (P=1.0). No statistically significant differences were identified in overall mortality rate (P=0.78) or survival probability (d30 P=0.19, d60 P=0.67, d90 P=0.68, last day of follow up P=0.68). Deaths were either attributed to COVID-19, or the infection was judged by the treating physician to have contributed to death. CONCLUSIONS Hospitalisation and mortality rates with molnupiravir were comparable to those with nirmatrelvir/ritonavir in high-risk patients with haematological malignancies and COVID-19. Molnupiravir is a plausible alternative to nirmatrelvir/ritonavir for COVID-19 treatment in patients with haematological malignancy.
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Affiliation(s)
- Jon Salmanton-García
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany.
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Philipp Koehler
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Barbora Weinbergerová
- Department of Internal Medicine - Hematology and Oncology, Masaryk University Hospital Brno, Brno, Czech Republic
| | - Natasa Čolović
- University Clinical Center Serbia, Medical Faculty University Belgrade, Belgrade, Serbia
| | - Iker Falces-Romero
- La Paz University Hospital, Madrid, Spain; CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Jens van Praet
- Department of Nephrology and Infectious diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | - Monika M Biernat
- Department of Haematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Federico Itri
- San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | - Lucia Prezioso
- Hospital University of Parma - Hematology and Bone Marrow Unit, Parma, Italy
| | - Carlo Tascini
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | | | | | - Mario Delia
- Hematology and Stem Cell Transplantation Unit, AOUC Policlinico, Bari, Italy
| | | | | | | | | | | | - Alberto López-García
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Mariana Criscuolo
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy
| | - Verena Petzer
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | | | - Ildefonso Espigado
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS / CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Uluhan Sili
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | | | - Nurettin Erben
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine Eskisehir Osmangazi University, Eskisehir, Turkey
| | | | | | | | - Martin Schönlein
- Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mirjana Mitrovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Nikola Pantic
- Clinic of Hematology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Maria Merelli
- Azienda Sanitaria Universitaria del Friuli Centrale, Udine, Italy
| | - Jorge Labrador
- Department of Hematology, Research Unit, Hospital Universitario de Burgos, Burgos, Spain; Facultad de Ciencias de la Salud, Universidad Isabel I, Burgos, Spain
| | - José-Ángel Hernández-Rivas
- Hospital Universitario Infanta Leonor, Madrid, Spain; Departmento de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Andreas Glenthøj
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | | | | | | | - Caroline Besson
- Centre Hospitalier de Versailles, Le Chesnay, France; Université Paris-Saclay, UVSQ, Inserm, Équipe "Exposome et Hérédité", CESP, Villejuif, France
| | - Milena Kohn
- Centre Hospitalier de Versailles, Le Chesnay, France; Université Paris-Saclay, UVSQ, Inserm, Équipe "Exposome et Hérédité", CESP, Villejuif, France
| | - Stefanie Gräfe
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; III. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ditte Stampe Hersby
- Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Elena Arellano
- Department of Hematology, University Hospital Virgen Macarena - University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS / CSIC), Universidad de Sevilla (Departamento de Medicina), Seville, Spain
| | - Gökçe Melis Çolak
- Department of Infectious Diseases and Clinical Microbiology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Dominik Wolf
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Medical University of Innsbruck (MUI), Innsbruck, Austria
| | - Monia Marchetti
- Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Anna Nordlander
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Ola Blennow
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Raul Cordoba
- Fundacion Jimenez Diaz University Hospital, Health Research Institute IIS-FJD, Madrid, Spain
| | - Bojana Mišković
- Center of Radiology, University Clinical Center of Serbia, Belgrade, Serbia
| | - Miloš Mladenović
- University Clinic for Orthopedic Surgery and Traumatology, University Clinical Center of Serbia, Belgrade, Serbia
| | | | - Alessandro Limongelli
- University Clinical Center Serbia, Medical Faculty University Belgrade, Belgrade, Serbia
| | - Laman Rahimli
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany
| | - Livio Pagano
- Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy; Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Oliver A Cornely
- University of Cologne, Faculty of Medicine, and University Hospital Cologne, Institute of Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany; University of Cologne, Faculty of Medicine, University Hospital Cologne, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD) and Excellence Center for Medical Mycology (ECMM), Cologne, Germany; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany; University of Cologne, Faculty of Medicine, and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany.
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4
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Infante MS, Salmanton-García J, Fernández-Cruz A, Marchesi F, Jaksic O, Weinbergerová B, Besson C, Duarte RF, Itri F, Valković T, Szotkovski T, Busca A, Guidetti A, Glenthøj A, Collins GP, Bonuomo V, Sili U, Seval GC, Machado M, Cordoba R, Blennow O, Abu-Zeinah G, Lamure S, Kulasekararaj A, Falces-Romero I, Cattaneo C, Van Doesum J, Piukovics K, Omrani AS, Magliano G, Ledoux MP, de Ramon C, Cabirta A, Verga L, López-García A, Da Silva MG, Stojanoski Z, Meers S, Lahmer T, Martín-Pérez S, Dávila-Vals J, Van Praet J, Samarkos M, Bilgin YM, Karlsson LK, Batinić J, Nordlander A, Schönlein M, Hoenigl M, Ráčil Z, Mladenović M, Hanakova M, Zambrotta GPM, De Jonge N, Adžić-Vukičević T, Nunes-Rodrigues R, Prezioso L, Navrátil M, Marchetti M, Cuccaro A, Calbacho M, Giordano A, Cornely OA, Hernández-Rivas JÁ, Pagano L. B-cell malignancies treated with targeted drugs and SARS-CoV-2 infection: A European Hematology Association Survey (EPICOVIDEHA). Front Oncol 2022; 12:992137. [PMID: 36276116 PMCID: PMC9583921 DOI: 10.3389/fonc.2022.992137] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/31/2022] [Indexed: 01/26/2023] Open
Abstract
Patients with lymphoproliferative diseases (LPD) are vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Here, we describe and analyze the outcome of 366 adult patients with chronic lymphocytic leukemia (CLL) or non-Hodgkin Lymphoma (NHL) treated with targeted drugs and laboratory-confirmed COVID-19 diagnosed between February 2020 and January 2022. Median follow-up was 70.5 days (IQR 0-609). Most used targeted drugs were Bruton-kinase inhibitors (BKIs) (N= 201, 55%), anti-CD20 other than rituximab (N=61, 16%), BCL2 inhibitors (N=33, 9%) and lenalidomide (N=28, 8%).Only 16.2% of the patients were vaccinated with 2 or more doses of vaccine at the onset of COVID-19. Mortality was 24% (89/366) on day 30 and 36%(134/366) on the last day of follow-up. Age >75 years (p<0.001, HR 1.036), active malignancy (p<0.001, HR 2.215), severe COVID-19 (p=0.017, HR 2.270) and admission to ICU (p<0.001, HR 5.751) were risk factors for mortality at last day of follow up. There was no difference in OS rates in NHL vs CLL patients (p=0.306), nor in patients treated with or without BKIs (p=0.151). Mortality in ICU was 66% (CLL 61%, NHL 76%). Overall mortality rate decreased according to vaccination status, being 39% in unvaccinated patients, 32% and 26% in those having received one or two doses, respectively, and 20% in patients with a booster dose (p=0.245). Overall mortality rate dropped from 41% during the first semester of 2020 to 25% at the last semester of 2021. These results show increased severity and mortality from COVID-19 in LPDs patients treated with targeted drugs.
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Affiliation(s)
| | - Jon Salmanton-García
- 2Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany,3Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany,*Correspondence: Jon Salmanton-García,
| | | | - Francesco Marchesi
- 5Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Ozren Jaksic
- 6Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
| | - Barbora Weinbergerová
- 7Department of Internal Medicine, Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czechia
| | | | | | - Federico Itri
- 9San Luigi Gonzaga Hospital - Orbassano, Orbassano, Italy
| | - Toni Valković
- 10University Hospital Centre Rijeka, Rijeka, Croatia,11Croatian Cooperative Group for Hematological Diseases (CROHEM), Zagreb, Croatia,12Faculty of Medicine and Faculty of Health Studies University of Rijeka, Rijeka, Croatia
| | | | - Alessandro Busca
- 14Stem Cell Transplant Center, AOU Citta’ della Salute e della Scienza, Turin, Italy
| | - Anna Guidetti
- 15Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Andreas Glenthøj
- 16Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Graham P. Collins
- 17NIHR Oxford Biomedical Research Centre, Churchill Hospital, Oxford, United Kingdom
| | - Valentina Bonuomo
- 18Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Uluhan Sili
- 19Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | | | - Marina Machado
- 21Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Raul Cordoba
- 22Health Research Institute IIS-FJD, Fundación Jimenez Diaz University Hospital, Madrid, Spain
| | - Ola Blennow
- 19Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Ghaith Abu-Zeinah
- 23Division of Hematology and Oncology, Weill Cornell Medicine, New York, NY, United States
| | - Sylvain Lamure
- 24Departement d’Hematologie Clinique, CHU de Montpellier, UMR-CNRS 5535, Universite de Montpellier, Montpellier, France
| | - Austin Kulasekararaj
- 25King’s College Hospital, London, United Kingdom,26King’s College London, London, United Kingdom
| | | | | | - Jaap Van Doesum
- 29University Medical Center Groningen, Groningen, Netherlands
| | - Klára Piukovics
- 30Department of Internal Medicine, Albert Szent-Györgyi Health Center, Faculty of Medicine University of Szeged, Szeged, Hungary
| | - Ali S. Omrani
- 31Communicable Disease Center, Hamad Medical Corporation, Doha, Qatar
| | | | | | - Cristina de Ramon
- 34Hematology Department, Hospital Universitario de Salamanca, Salamanca, Spain,35IBSAL, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spain
| | - Alba Cabirta
- 36Department of Hematology, Vall d’Hebron Hospital Universitari, Experimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron Barcelona, Spain,37Hospital Campus, Barcelona, Spain,38Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Luisa Verga
- 39Azienda Ospedaliera San Gerardo - Monza, Monza, Italy,40Università Milano-Bicocca, Milan, Italy
| | - Alberto López-García
- 41Health Research Institute IIS-FJD, Fundacion Jimenez Diaz University Hospital, Madrid, Spain
| | | | | | | | - Tobias Lahmer
- 45Medizinische Klinik II, Klinikum rechts der Isar, TU München, Munich, Germany
| | | | | | - Jens Van Praet
- 47Department of Nephrology and Infectious Diseases, AZ Sint-Jan Brugge-Oostende AV, Brugge, Belgium
| | | | | | - Linda Katharina Karlsson
- 16Department of Hematology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | | | - Anna Nordlander
- 19Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Martin Schönlein
- 51Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Hoenigl
- 52Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA, United States,53Clinical and Translational Fungal-Working Group, University of California San Diego, La Jolla, CA, United States,54Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Zdeněk Ráčil
- 55Institute of Hematology and Blood Transfusion, Prague, Czechia
| | | | | | | | - Nick De Jonge
- 57Amsterdam UMC, location VUmc, Amsterdam, Netherlands
| | | | | | - Lucia Prezioso
- 58U.O. Ematologia e Centro Trapianti Midollo Osseo, Ospedale Maggiore, Parma, Italy
| | | | - Monia Marchetti
- 60Hematology and BMT Unit, Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Annarosa Cuccaro
- 61Hematology Unit, Center for Translational Medicine, Azienda USL Toscana NordOvest, Livorno, Italy
| | - Maria Calbacho
- 62Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Antonio Giordano
- 63Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli - IRCCS, Rome, Italy,64Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Oliver A. Cornely
- 2Faculty of Medicine and University Hospital Cologne, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany,3Faculty of Medicine and University Hospital Cologne, Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany,65University of Cologne, Faculty of Medicine and University Hospital Cologne, Clinical Trials Centre Cologne (ZKS Köln), Cologne, Germany,66University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne, Germany,67German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany
| | | | - Livio Pagano
- 64Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy
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