Outcomes of SARS-CoV-2 infection in Ph-neg chronic myeloproliferative neoplasms : results from the EPICOVIDEHA registry
Marchetti, Monia (Azienda Ospedaliera Nazionale)
Salmanton-García, Jon (University of Cologne, Cologne, Germany)
El-Ashwah, Shaimaa (Mansoura University. Oncology Center)
Verga, Luisa (Università Milano-Bicocca)
Itri, Federico (San Luigi Gonzaga Hospital-Orbassano, Orbassano, Italy)
Ráčil, Zdeněk (Institute of Hematology and Blood Transfusion, Prague, Czech Republic)
Dávila-Valls, Julio (Hospital Nuestra Señora de Sonsoles (Àvila))
Martín-Pérez, Sonia (Hospital Nuestra Señora de Sonsoles (Àvila))
Van Doesum, Jaap (University Medical Center Groningen, The Netherlands)
Passamonti, Francesco (University Insubria, Varese, Italy)
Abu-Zeinah, Ghaith (Division of Hematology and Oncology, Weill Cornell Medicine, New York)
Farina, Francesca (IRCCS Ospedale San Raffaele, Milan, Italy)
López-García, Alberto (Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz)
Dragonetti, Giulia (Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Rome)
Cattaneo, Chiara (Hematology Unit, ASST-Spedali Civili, Brescia, Italy)
Gomes Da Silva, Maria (Portuguese Institute of Oncology, Lisbon, Portugal)
Bilgin, Yavuz M. (Department of Internal Medicine, ADRZ, Goes, The Netherlands)
Žák, Pavel (University Hospital Hradec Kralove (República Txeca))
Petzer, Verena (Medical University of Innsbruck, Austria)
Glenthøj, Andreas (Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark)
Espigado, Ildefonso (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Buquicchio, Caterina (Ospedale Dimiccoli Barletta, Italy)
Bonuomo, Valentina (University of Verona, Italy)
Prezioso, Lucia (Hospital University of Parma, Italy)
Meers, Stef (AZ KLINA, Brasschaat, Belgium)
Duarte, Rafael (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Bergantim, Rui
Jakšić, Ozren
Čolović, Natasha
Blennow, Ola
Cernan, Martin
Schönlein, Martin
Samarkos, Michail
Mitra, Maria Enza
Magliano, Gabriele
Maertens, Johan
Ledoux, Marie-Pierre
Jiménez, Moraima (Hospital Universitari Vall d'Hebron)
Demirkan, Fatih
Collins, Graham
Cabirta, Alba (Hospital Universitari Vall d'Hebron)
Gräfe, Stefanie K.
Nordlander, Anna
Wolf, Dominik
Arellano, Elena
Cordoba, Raul
Hanakova, Michaela
Zambrotta, Giovanni
Nunes Rodrigues, Raquel
Limberti, Giulia
Marchesi, Francesco
Cornely, Oliver A.
Pagano, Livio
Universitat Autònoma de Barcelona

Date:	2023
Abstract:	Patients with Philadelphia-negative chronic myeloproliferative neoplasms (MPN) typically incur high rates of infections and both drugs and comorbidities may modulate infection risk. The present study aims to assess the effect of immunosuppressive agents on clinical outcomes of MPN patients affected by the coronavirus disease 2019 (COVID-19). This is an observational study. We specifically searched and analyzed MPN patients collected by EPICOVIDEHA online registry, which includes individuals with hematological malignancies diagnosed with COVID-19 since February 2020. Overall, 398 patients with MPN were observed for a median of 76 days [interquartile range (IQR): 19-197] after detection of SARS-CoV2 infection. Median age was 69 years (IQR: 58-77) and 183 individuals (46%) had myelofibrosis (MF). Overall, 121 patients (30%) of the whole cohort received immunosuppressive therapies including steroids, immunomodulatory drugs, or JAK inhibitors. Hospitalization and consecutive admission to intensive care unit was required in 216 (54%) and 53 patients (13%), respectively. Risk factors for hospital admission were identified by multivariable logistic regression and include exposure to immunosuppressive therapies [odds ratio (OR): 2. 186; 95% confidence interval (CI): 1. 357-3. 519], age ⩾70 years, and comorbidities. The fatality rate was 22% overall and the risk of death was independently increased by age ⩾70 years [hazard ratio (HR): 2. 191; 95% CI: 1. 363-3. 521], previous comorbidities, and exposure to immunosuppressive therapies before the infection (HR: 2. 143; 95% CI: 1. 363-3. 521). COVID-19 infection led to a particularly dismal outcome in MPN patients receiving immunosuppressive agents or reporting multiple comorbidities. Therefore, specific preventive strategies need to be tailored for such individuals. EPICOVIDEHA registry reports inferior outcomes of COVID-19 in patients with Philadelphia-negative chronic myeloproliferative neoplasms receiving immunosuppressive therapies. Patients with Philadelphia-negative chronic myeloproliferative neoplasms (MPN) incur high rates of infections during the course of their disease. The present study was aimed at assessing which patient characteristics predicted a worse outcome of SARS-COV-2 infection in individuals with MPN. To pursue this objective, the researchers analyzed the data collected by EPICOVIDEHA, an international online registry, which includes individuals with hematological malignancies diagnosed with COVID-19 since February 2020. The database provided clinical data of 398 patients with MPN incurring COVID-19: Hospitalization was required in 54% of the patients, and the risk of being hospitalized for severe COVID-19 was independently predicted by Overall, 22% of MPN patients deceased soon after COVID-19 and the risk of death was independently increased over twofold by In conclusion, COVID-19 infection led to a particularly dismal outcome in MPN patients receiving immunosuppressive agents, including JAK inhibitors, or reporting multiple comorbidities. Therefore, specific preventive strategies need to be tailored for such individuals.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	COVID-19 ; Essential thrombocytemia ; Hydroxyurea ; Myelofibrosis ; Philadelphia-negative chronic myeloproliferative neoplasms ; Polycythemia vera ; Ruxolitinib ; SARS-CoV-2
Published in:	Therapeutic Advances in Hematology, Vol. 14 (march 2023) , ISSN 2040-6215

DOI: 10.1177/20406207231154706
PMID: 36923264

15 p, 694.5 KB

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