Omicron SARS-CoV-2 infection management and outcomes in patients with hematologic disease and recipients of cell therapy
Piñana, José Luis (INCLIVA Institut d'Investigació Sanitària)
Vazquez, Lourdes (Universidad de Salamanca)
Heras, Inmaculada (Hospital General Universitario Morales Meseguer (Múrcia))
Aiello, Tommaso Francesco (Hospital Clínic i Provincial de Barcelona)
López-Corral, L. (Universidad de Salamanca)
Arroyo, I. (INCLIVA Institut d'Investigació Sanitària)
Soler-Espejo, E. (Hospital General Universitario Morales Meseguer (Múrcia))
Garcia Cadenas, Irene (Institut de Recerca Sant Pau)
Garcia-Gutierrez, V. (Hospital Universitario Ramón y Cajal (Madrid))
Aroca, C. (Hospital General Universitario Morales Meseguer (Múrcia))
Chorão, Pedro (Hospital Universitari i Politècnic La Fe (València))
Olave, M.T. (Hospital Clínico Universitario "Lozano Blesa" de Zaragoza)
Lopez-Jimenez, J. (Hospital Universitario Ramón y Cajal (Madrid))
Gómez, M.A. (Universidad de Salamanca)
Arellano, E. (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Cuesta-Casas, M. (Hospital Regional Universitario Carlos Haya (Málaga))
Avendaño-Pita, A. (Universidad de Salamanca)
González-Santillana, C. (Hospital Universitario de Fuenlabrada ( Madrid))
Hernández Rivas, José Ángel (Hospital Universitario Infanta Leonor)
Roldán-Pérez, Alicia (Hospital Infanta Sofia)
Mico-Cerdá, M. (INCLIVA Institut d'Investigació Sanitària)
Guerreiro, M. (Hospital Clínico Universitario "Lozano Blesa" de Zaragoza)
Morell, J. (INCLIVA Institut d'Investigació Sanitària)
Rodriguez-Galvez, P. (INCLIVA Institut d'Investigació Sanitària)
Labrador, Jorge (Hospital Universitario de Burgos)
Campos Beltrán, Diana (University of Lübeck)
Cedillo, Á. (Hematopoietic Stem Cell Transplantation and Cell Therapy Group (GETH-TC) office)
Vidal, C.G. (Hospital General Universitario Morales Meseguer (Múrcia))
Martino Bofarull, Rodrigo (Institut de Recerca Sant Pau)
Solano, Carlos (Universitat de València)
Universitat Autònoma de Barcelona

Fecha:	2024
Resumen:	Introduction: Scarce real-life data exists for COVID-19 management in hematologic disease (HD) patients in the Omicron era. Purpose: To assess the current clinical management and outcome of SARS-CoV-2 infection diagnosed, identify the risk factors for severe outcomes according to the HD characteristics and cell therapy procedures in a real-world setting. Methods: A retrospective observational registry led by the Spanish Transplant Group (GETH-TC) with 692 consecutive patients with HD from December 2021 to May 2023 was analyzed. Results: Nearly one-third of patients (31%) remained untreated and presented low COVID-19-related mortality (0. 9%). Nirmatrelvir/ritonavir was used mainly in mild COVID-19 cases in the outpatient setting (32%) with a low mortality (1%), while treatment with remdesivir was preferentially administered in moderate-to-severe SARS-CoV-2 infection cases during hospitalization (35%) with a mortality rate of 8. 6%. The hospital admission rate was 23%, while 18% developed pneumonia. COVID-19-related mortality in admitted patients was 14%. Older age, autologous hematopoietic stem cell transplantation (SCT), chimeric antigen receptor T-cell therapy, corticosteroids and incomplete vaccination were factors independently associated with COVID-19 severity and significantly related with higher rates of hospital admission and pneumonia. Incomplete vaccination status, treatment with prior anti-CD20 monoclonal antibodies, and comorbid cardiomyopathy were identified as independent risk factors for COVID-19 mortality. Conclusions: The results support that, albeit to a lower extent, COVID-19 in the Omicron era remains a significant problem in HD patients. Complete vaccination (3 doses) should be prioritized in these immunocompromised patients. The identified risk factors may help to improve COVID-19 management to decrease the rate of severe disease, ICU admissions and mortality.
Derechos:	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, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	COVID - 19 ; SARS-CoV-2 ; Hematologic disease ; Immunocompromised ; Risk factors
Publicado en:	Frontiers in Oncology, Vol. 14 (2024) , p. 1389345, ISSN 2234-943X

DOI: 10.3389/fonc.2024.1389345
PMID: 39015498

18 p, 1.4 MB

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