COVID-19 Outcomes in Patients with Hematologic Malignancies in the Era of COVID-19 Vaccination and the Omicron Variant-Reference-Cited by-同舟云学术

COVID-19 Outcomes in Patients with Hematologic Malignancies in the Era of COVID-19 Vaccination and the Omicron Variant

Published:2024-01-16 Issue:2 Volume:16 Page:379
ISSN:2072-6694
Container-title:Cancers
language:en
Short-container-title:Cancers

Author:

Martínez-López Joaquín¹^ORCID,de la Cruz Javier²,Gil-Manso Rodrigo¹^ORCID,Yuste Víctor Jiménez³,Aspa-Cilleruelo José María⁴^ORCID,Escobar Cristian Escolano⁵,López-Jiménez Javier⁶^ORCID,Duarte Rafael⁷,Yerovi Cristina Jacome⁸,Hernández-Rivas José-Ángel⁹^ORCID,Herráez Regina¹⁰,Quiroz-Cervantes Keina¹¹,Bustelos-Rodriguez Rosalía¹²,Benavente Celina¹³,Martínez Barranco Pilar¹⁴,Bastos Oteiro Mariana¹⁵,Alegre Adrián¹⁶^ORCID,Pérez-Oteyza Jaime¹⁷^ORCID,Ruiz Elena¹⁸,Marcheco-Pupo Eriel Alexis¹⁹,Cedillo Ángel²⁰,de Soto Álvarez Teresa³,García Ramirez Patricia⁴,Alonso Trillo Rosalía⁵,Herrera Pilar⁶,Bengochea Casado María Luisa⁸,Arroyo Barea Andrés¹,Martin De Bustamante Jose Manuel³,Ortiz Javier¹⁶^ORCID,Calbacho Robles María¹,García-Suárez Julio⁴^ORCID

Affiliation:

1. Hematology Department, Hospital Universitario 12 de Octubre, imas12 Madrid, Universidad Complutense, CNIO-ISCIII, CIBERONC, 28041 Madrid, Spain

2. imas12 Research Institute, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain

3. Hematology Department, Hospital Universitario La Paz, 28046 Madrid, Spain

4. Hospital Universitario Príncipe de Asturias, Universidad de Alcalá, 28805 Madrid, Spain

5. Hematology Department, Hospital Universitario de Getafe, 28905 Madrid, Spain

6. Hematology Department, Hospital Universitario Ramón Y Cajal, 28034 Madrid, Spain

7. Hematology Department, Hospital Universitario Puerta de Hierro Majadahonda, 28222 Madrid, Spain

8. Hematology Department, Hospital Universitario Severo Ochoa, 28914 Madrid, Spain

9. Hematology Department, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain

10. Hematology Department, Hospital Universitario Infanta Sofía, 28702 Madrid, Spain

11. Hematology Department, Hospital Universitario de Móstoles, 28935 Madrid, Spain

12. Hematology Department, Hospital Universitario del Sureste, 28500 Madrid, Spain

13. Hematology Department, Hospital Clínico San Carlos, 28040 Madrid, Spain

14. Hematology Department, Hospital Universitario Fundación Alcorcón, 28922 Madrid, Spain

15. Hematology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, 28009 Madrid, Spain

16. Hematology Department, Hospital Universitario de La Princesa, IIS-HUP, 28006 Madrid, Spain

17. Hematology Department, Hospital Universitario HM Sanchinarro, 28050 Madrid, Spain

18. Hematology Department, Hospital Universitario del Tajo, 28300 Madrid, Spain

19. Hematology Department, Hospital Universitario Infanta Cristina, 28981 Madrid, Spain

20. Asociación Madrileña de Hematología y Hemoterapia (AMHH), 28010 Madrid, Spain

Abstract

A greater understanding of clinical trends in COVID-19 outcomes among patients with hematologic malignancies (HM) over the course of the pandemic, particularly the Omicron era, is needed. This ongoing, observational, and registry-based study with prospective data collection evaluated COVID-19 clinical severity and mortality in 1818 adult HM patients diagnosed with COVID-19 between 27 February 2020 and 1 October 2022, at 31 centers in the Madrid region of Spain. Of these, 1281 (70.5%) and 537 (29.5%) were reported in the pre-Omicron and Omicron periods, respectively. Overall, patients aged ≥70 years (odds ratio 2.16, 95% CI 1.64–2.87), with >1 comorbidity (2.44, 1.85–3.21), or with an underlying HM of chronic lymphocytic leukemia (1.64, 1.19–2.27), had greater odds of severe/critical COVID-19; odds were lower during the Omicron BA.1/BA.2 (0.28, 0.2–0.37) or BA.4/BA.5 (0.13, 0.08–0.19) periods and among patients vaccinated with one or two (0.51, 0.34–0.75) or three or four (0.22, 0.16–0.29) doses. The hospitalization rate (75.3% [963/1279], 35.7% [191/535]), rate of intensive care admission (30.0% [289/963], 14.7% [28/191]), and mortality rate overall (31.9% [409/1281], 9.9% [53/536]) and in hospitalized patients (41.3% [398/963], 22.0% [42/191]) decreased from the pre-Omicron to Omicron period. Age ≥70 years was the only factor associated with higher mortality risk in both the pre-Omicron (hazard ratio 2.57, 95% CI 2.03–3.25) and Omicron (3.19, 95% CI 1.59–6.42) periods. Receipt of prior stem cell transplantation, COVID-19 vaccination(s), and treatment with nirmatrelvir/ritonavir or remdesivir were associated with greater survival rates. In conclusion, COVID-19 mortality in HM patients has decreased considerably in the Omicron period; however, mortality in hospitalized HM patients remains high. Specific studies should be undertaken to test new treatments and preventive interventions in HM patients.

Funder

FLL Research Grant 2020

Publisher

MDPI AG

Subject

Cancer Research,Oncology

Link

https://www.mdpi.com/2072-6694/16/2/379/pdf

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