Patients with Hematological Malignancies Treated with T-Cell or B-Cell Immunotherapy Remain at High Risk of Severe Forms of COVID-19 in the Omicron Era
Jeremie Zerbit,
Marion Detroit,
Antoine Meyer,
Justine Decroocq,
Benedicte Deau-Fischer,
Paul Deschamps,
Rudy Birsen,
Johanna Mondesir,
Patricia Franchi,
Elsa Miekoutima,
Corinne Guerin,
Rui Batista,
Didier Bouscary,
Lise Willems,
Marguerite Vignon
Affiliations
Jeremie Zerbit
Department of Pharmacy, Hospital at Home, University Hospitals of Paris, 75014 Paris, France
Marion Detroit
Clinical Pharmacy, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France
Antoine Meyer
Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France
Justine Decroocq
Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France
Benedicte Deau-Fischer
Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France
Paul Deschamps
Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France
Rudy Birsen
Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France
Johanna Mondesir
Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France
Patricia Franchi
Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France
Elsa Miekoutima
Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France
Corinne Guerin
Clinical Pharmacy, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France
Rui Batista
Clinical Pharmacy, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France
Didier Bouscary
Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France
Lise Willems
Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France
Marguerite Vignon
Clinical Hematology, Cochin Hospital, University Hospitals of Paris, 75014 Paris, France
Background: Patients with hematological malignancies are at greater risk of severe COVID-19 and have been prioritized for COVID-19 vaccination. A significant proportion of them have an impaired vaccine response, both due to the underlying disease and to the treatments. Methods: We conducted a prospective observational study to identify the specific risks of the outpatient population with hematological diseases. Result: Between 22 December 2021 to 12 February 2022, we followed 338 patients of which 16.9% (n = 57) developed SARS-CoV-2 infection despite previous vaccination (94.7%). COVID-19 patients were more likely to have received immunotherapy (85.5% vs. 41%, p −4), and particularly anti-CD20 monoclonal antibodies (40% vs. 14.9%, p −4) and Bruton’s tyrosine kinase inhibitors (BTKi) (7.3% vs. 0.7%, p −2). There was no significant difference in demographic characteristics or hematological malignancies between COVID-19-positive and non-positive patients. Patients hospitalized for COVID-19 had more frequently received immunotherapy than patients with asymptomatic or benign forms (100% vs. 77.3%, p p n = 102) were less likely to be COVID-19-positive (4.9 vs. 22%, p < 0.05) without significant difference in hospitalization rates. Conclusion: In the immunocompromised population of patients with hematological malignancies, the underlying treatment of blood cancer by immunotherapy appears to be a risk factor for SARS-CoV-2 infection and for developing a severe form.
