Article Dans Une Revue Blood Année : 2022

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

Livio Pagano (1) , Jon Salmanton-García (2) , Francesco Marchesi (1) , Ola Blennow (3) , Maria Gomes da Silva (4) , Andreas Glenthøj (5) , Jaap van Doesum (6) , Yavuz Bilgin (6) , Alberto Lopez-Garcia (7) , Federico Itri (8) , Raquel Nunes Rodrigues (4) , Barbora Weinbergerová (9) , Francesca Farina (8) , Giulia Dragonetti (10) , Caroline Berg Venemyr (5) , Jens van Praet (11) , Ozren Jaksic (12) , Toni Valkovic (13) , Iker Falces-Romero (14) , Sonia Martin-Perez (15) , Moraima Jiménez (16) , Julio Davila-Valls (15) , Martin Schonlein (17) , Emanuele Ammatuna (16) , Stef Meers (18) , Mario Delia (19) , Zlate Stojanoski (20) , Anna Nordlander (3) , Tobias Lahmer (21) , László Imre Pinczés (22) , Caterina Buquicchio (23) , Klára Piukovics (24) , Irati Ormazabal-Velez (25) , Nicola Stefano Fracchiolla (26) , Michail Samarkos (27) , Gustavo-Adolfo Mendez (28) , José-Ángel Hernández-Rivas (29) , Ildefonso Espigado (30) , Martin Cernan (31) , Verena Petzer (32) , Sylvain Lamure (33, 34) , Roberta Di Blasi (35) , Joyce Marques de Almeida (36) , Michelina Dargenio (37) , Monika Maria Biernat (36) , Mariarita Sciumè (38) , Cristina de Ramón (39) , Nick Alexander de Jonge (40) , Josip Batinic (12) , Avinash Aujayeb (41) , Monia Marchetti (42) , Guillemette Fouquet (43) , Noemi Fernández Escalada (44) , Giovanni Paolo Maria Zambrotta (45) , Maria Vittoria Sacchi (42) , Anna Guidetti (46) , Fatih Demirken (47) , Lucia Prezioso (48) , Zdenek Racil (49) , Marcio Nucci (50) , Miloš Mladenovic (51) , Raphaël Lievin (35) , Michaela Hanakova (49) , Stefanie Grafe (17) , Uluhan Sili (52) , Marina Machado (29) , Chiara Cattaneo (53) , Tatjana Adzic-Vukicevic (51) , Luisa Verga (45) , Jorge Labrador (54) , Laman Rahimli (2) , Matteo Bonanni (55) , Francesco Passamonti (56) , Antonio Pagliuca (57) , Paolo Corradini (58) , Martin Hoenigl (59) , Philipp Koehler (60) , Alessandro Busca (61) , Oliver Cornely (2)
1 Unicatt - Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma]
2 University Hospital of Cologne [Cologne]
3 Karolinska University Hospital [Stockholm]
4 IPO Porto - Instituto Português de Oncologia do Porto / Portuguese Oncology Institute of Porto
5 KUH - Copenhagen University Hospital [Denmark] = Københavns Universitetshospital [Danmark]
6 UMCG - University Medical Center Groningen [Groningen]
7 Hospital Universitario HM Sanchinarro [Madrid, Spain]
8 IRCCS Ospedale San Raffaele [Milan, Italy]
9 University Hospital Brno
10 Fondazione Policlinico Universitario Agostino Gemelli IRCCS
11 Openbare Bibliotheek Brugge
12 University of Zagreb
13 University of Rijeka
14 La Paz University Hospital
15 UNICA - Universidad de Ciego de Avila
16 UAB - Universitat Autònoma de Barcelona = Autonomous University of Barcelona = Universidad Autónoma de Barcelona
17 UKE - Universitaetsklinikum Hamburg-Eppendorf = University Medical Center Hamburg-Eppendorf [Hamburg]
18 VIB - Vlaams Instituut voor Biotechnologie = Flanders Institute for Biotechnology [Ghent]
19 Polytechnic University of Bari / Politecnico di Bari
20 Institute of Public Health of Republic of North Macedonia [Skopje]
21 University-Hospital Munich-Großhadern [München]
22 University of Debrecen
23 ICB - Istituto di chimica biomolecolare [Padova, Italy]
24 University of Szeged [Szeged]
25 UNAV - Universidad de Navarra [Pamplona]
26 Fondazione IRCCS Istituto Nazionale Tumori - National Cancer Institute [Milan]
27 University of Athens Medical School [Athens]
28 UCA - Pontificia Universidad Católica Argentina (Universidad Católica Argentina) [Buenos Aires, Argentina] = Pontifical Catholic University of Argentina = Université catholique argentine
29 Hospital General Universitario "Gregorio Marañón" [Madrid]
30 Universidad de Sevilla = University of Seville = Université de Seville
31 Univerzita Palackého [Olomouci]
32 IMU - Innsbruck Medical University = Medizinische Universität Innsbruck
33 CHU Montpellier = Montpellier University Hospital
34 IGMM - Institut de Génétique Moléculaire de Montpellier
35 AP-HP - Hopital Saint-Louis [AP-HP]
36 Wrocław Medical University
37 Università del Salento = University of Salento [Lecce]
38 Unit of Melanoma Medical Oncology [Fondazione IRCCS Istituto Nazionale Tumori, Milan]
39 Universidad de Salamanca [España] = University of Salamanca [Spain]
40 Amsterdam UMC - Amsterdam University Medical Centers
41 Newcastle University [Newcastle]
42 DISIT - Dipartimento di Scienze e Innovazione Tecnologica [Alessandria]
43 AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
44 Hospital Universitario Marqués de Valdecilla = Marqués de Valdecilla University Hospital [Santander]
45 UNIMIB - Università degli Studi di Milano-Bicocca = University of Milano-Bicocca
46 Human Tumor Immunobiology Unit [Fondazione IRCCS Istituto Nazionale dei Tumori, Milan]
47 DEÜ - Dokuz Eylül Üniversitesi = Dokuz Eylül University [Izmir]
48 UNIPR - Università degli studi di Parma = University of Parma
49 IPP PRAGUE - Institute of Plasma Physics, Association EURATOM
50 UFRJ - Universidade Federal do Rio de Janeiro [Brasil] = Federal University of Rio de Janeiro [Brazil] = Université fédérale de Rio de Janeiro [Brésil]
51 University of Belgrade [Belgrade]
52 Marmara University [Kadıköy - İstanbul]
53 UniBs - Università degli Studi di Brescia = University of Brescia
54 Universidad de Burgos = University of Burgos
55 Unicatt - Università cattolica del Sacro Cuore [Milano]
56 Uninsubria - Universitá degli Studi dell’Insubria = University of Insubria [Varese]
57 King‘s College London
58 UNIMI - Università degli Studi di Milano = University of Milan
59 UC San Diego - University of California [San Diego]
60 Universität zu Köln = University of Cologne
61 Clinique Turin
Barbora Weinbergerová
Jens van Praet
László Imre Pinczés
Joyce Marques de Almeida
Monika Maria Biernat
Avinash Aujayeb
Miloš Mladenovic
Raphaël Lievin
Antonio Pagliuca

Résumé

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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hal-03791153 , version 1 (29-09-2022)

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Livio Pagano, Jon Salmanton-García, Francesco Marchesi, Ola Blennow, Maria Gomes da Silva, et al.. Breakthrough COVID-19 in vaccinated patients with hematologic malignancies: results from EPICOVIDEHA survey. Blood, 2022, ⟨10.1182/blood.2022017257/1922289/blood.2022017257.pdf⟩. ⟨hal-03791153⟩
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