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

Livio Pagano; Jon Salmanton-García; Francesco Marchesi; Ola Blennow; Maria Gomes da Silva; Andreas Glenthøj; Jaap van Doesum; Yavuz Bilgin; Alberto Lopez-Garcia; Federico Itri; Raquel Nunes Rodrigues; Barbora Weinbergerová; Francesca Farina; Giulia Dragonetti; Caroline Berg Venemyr; Jens van Praet; Ozren Jaksic; Toni Valkovic; Iker Falces-Romero; Sonia Martin-Perez; Moraima Jiménez; Julio Davila-Valls; Martin Schonlein; Emanuele Ammatuna; Stef Meers; Mario Delia; Zlate Stojanoski; Anna Nordlander; Tobias Lahmer; László Imre Pinczés; Caterina Buquicchio; Klára Piukovics; Irati Ormazabal-Velez; Nicola Stefano Fracchiolla; Michail Samarkos; Gustavo-Adolfo Mendez; José-Ángel Hernández-Rivas; Ildefonso Espigado; Martin Cernan; Verena Petzer; Sylvain Lamure; Roberta Di Blasi; Joyce Marques de Almeida; Michelina Dargenio; Monika Maria Biernat; Mariarita Sciumè; Cristina de Ramón; Nick Alexander de Jonge; Josip Batinic; Avinash Aujayeb; Monia Marchetti; Guillemette Fouquet; Noemi Fernández Escalada; Giovanni Paolo Maria Zambrotta; Maria Vittoria Sacchi; Anna Guidetti; Fatih Demirken; Lucia Prezioso; Zdenek Racil; Marcio Nucci; Miloš Mladenovic; Raphaël Lievin; Michaela Hanakova; Stefanie Grafe; Uluhan Sili; Marina Machado; Chiara Cattaneo; Tatjana Adzic-Vukicevic; Luisa Verga; Jorge Labrador; Laman Rahimli; Matteo Bonanni; Francesco Passamonti; Antonio Pagliuca; Paolo Corradini; Martin Hoenigl; Philipp Koehler; Alessandro Busca; Oliver Cornely

doi:10.1182/blood.2022017257/1922289/blood.2022017257.pdf

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

Journal article

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

Livio Pagano, Jon Salmanton-García, Francesco Marchesi, Ola Blennow, Maria Gomes da Silva, Andreas Glenthøj, Jaap van Doesum, Yavuz Bilgin, Alberto Lopez-Garcia, Federico Itri, …

Blood

29/09/2022

DOI: https://doi.org/10.1182/blood.2022017257/1922289/blood.2022017257.pdf

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.

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Title: Breakthrough COVID-19 in vaccinated patients with hematologic malignancies: results from EPICOVIDEHA survey
Creators - without role: Livio Pagano - Università Cattolica del Sacro Cuore
Jon Salmanton-García - University Hospital Cologne
Francesco Marchesi - Università Cattolica del Sacro Cuore
Ola Blennow - Karolinska University Hospital
Maria Gomes da Silva - IPO Porto
Andreas Glenthøj - Copenhagen University Hospital
Jaap van Doesum - University Medical Center Groningen
Yavuz Bilgin - University Medical Center Groningen
Alberto Lopez-Garcia - Hospital Universitario HM Sanchinarro
Federico Itri - IRCCS Ospedale San Raffaele
Raquel Nunes Rodrigues - IPO Porto
Barbora Weinbergerová - University Hospital Brno
Francesca Farina - IRCCS Ospedale San Raffaele
Giulia Dragonetti - Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Caroline Berg Venemyr - Copenhagen University Hospital
Jens van Praet - Openbare Bibliotheek Brugge
Ozren Jaksic - University of Zagreb
Toni Valkovic - University of Rijeka
Iker Falces-Romero - La Paz University Hospital
Sonia Martin-Perez - Universidad de Ciego de Ávila
Moraima Jiménez - Universitat Autònoma de Barcelona
Julio Davila-Valls - Universidad de Ciego de Ávila
Martin Schonlein - University Medical Center Hamburg-Eppendorf
Emanuele Ammatuna - Universitat Autònoma de Barcelona
Stef Meers - VIB [Belgium]
Mario Delia - Polytechnic University of Bari
Zlate Stojanoski - Institute of Public Health of Republic of North Macedonia [Skopje]
Anna Nordlander - Karolinska University Hospital
Tobias Lahmer - University-Hospital Munich-Großhadern [München]
László Imre Pinczés - University of Debrecen
Caterina Buquicchio - Istituto di Chimica Biomolecolare
Klára Piukovics - University of Szeged
Irati Ormazabal-Velez - Universidad de Navarra
Nicola Stefano Fracchiolla - Fondazione IRCCS Istituto Nazionale Tumori - National Cancer Institute [Milan]
Michail Samarkos - National and Kapodistrian University of Athens
Gustavo-Adolfo Mendez - Pontificia Universidad Católica Argentina
José-Ángel Hernández-Rivas - Hospital General Universitario Gregorio Marañón
Ildefonso Espigado - Universidad de Sevilla
Martin Cernan - Univerzita Palackého [Olomouci]
Verena Petzer - Innsbruck Medical University
Sylvain Lamure - Centre Hospitalier Universitaire de Montpellier
Roberta Di Blasi - Hôpital Saint-Louis
Joyce Marques de Almeida - Wroclaw Medical University
Michelina Dargenio - University of Salento
Monika Maria Biernat - Wroclaw Medical University
Mariarita Sciumè - Unit of Melanoma Medical Oncology [Fondazione IRCCS Istituto Nazionale Tumori, Milan]
Cristina de Ramón - Universidad de Salamanca
Nick Alexander de Jonge - Amsterdam University Medical Centers
Josip Batinic - University of Zagreb
Avinash Aujayeb - Newcastle University [Newcastle]
Monia Marchetti - Dipartimento di Scienze e Innovazione Tecnologica [Alessandria]
Guillemette Fouquet - Assistance Publique – Hôpitaux de Paris
Noemi Fernández Escalada - Marqués de Valdecilla University Hospital
Giovanni Paolo Maria Zambrotta - University of Milano-Bicocca
Maria Vittoria Sacchi - Dipartimento di Scienze e Innovazione Tecnologica [Alessandria]
Anna Guidetti - Human Tumor Immunobiology Unit [Fondazione IRCCS Istituto Nazionale dei Tumori, Milan]
Fatih Demirken - Dokuz Eylül University
Lucia Prezioso - University of Parma
Zdenek Racil - Institute of Plasma Physics, Association EURATOM
Marcio Nucci - Universidade Federal do Rio de Janeiro
Miloš Mladenovic - University of Belgrade
Raphaël Lievin - Hôpital Saint-Louis
Michaela Hanakova - Institute of Plasma Physics, Association EURATOM
Stefanie Grafe - University Medical Center Hamburg-Eppendorf
Uluhan Sili - Marmara University
Marina Machado - Hospital General Universitario Gregorio Marañón
Chiara Cattaneo - University of Brescia
Tatjana Adzic-Vukicevic - University of Belgrade
Luisa Verga - University of Milano-Bicocca
Jorge Labrador - Universidad de Burgos
Laman Rahimli - University Hospital Cologne
Matteo Bonanni - Università Cattolica del Sacro Cuore
Francesco Passamonti - University of Insubria
Antonio Pagliuca - King‘s College London
Paolo Corradini - University of Milan
Martin Hoenigl - University of California [San Diego]
Philipp Koehler - University of Cologne
Alessandro Busca - Clinique Turin
Oliver Cornely - University Hospital Cologne
Publication Details: Blood
Identifiers: 9941490509311
Academic Unit: Institut de Génétique Moléculaire de Montpellier - IGMM
Language: English
Resource Type: Journal article
Local Fields: hal-03791153