Frontiers in Oncology (Jun 2024)

Omicron SARS-CoV-2 infection management and outcomes in patients with hematologic disease and recipients of cell therapy

  • José Luis Piñana,
  • José Luis Piñana,
  • Lourdes Vazquez,
  • Inmaculada Heras,
  • Tommaso Francesco Aiello,
  • Lucia López-Corral,
  • Ignacio Arroyo,
  • Ignacio Arroyo,
  • Eva Soler-Espejo,
  • Irene García-Cadenas,
  • Valentín Garcia-Gutierrez,
  • Cristina Aroca,
  • Pedro Chorao,
  • María T. Olave,
  • Javier Lopez-Jimenez,
  • Marina Acera Gómez,
  • Elena Arellano,
  • Marian Cuesta-Casas,
  • Alejandro Avendaño-Pita,
  • Clara González-Santillana,
  • José Ángel Hernández-Rivas,
  • Alicia Roldán-Pérez,
  • Mireia Mico-Cerdá,
  • Mireia Mico-Cerdá,
  • Manuel Guerreiro,
  • Julia Morell,
  • Julia Morell,
  • Paula Rodriguez-Galvez,
  • Paula Rodriguez-Galvez,
  • Jorge Labrador,
  • Diana Campos,
  • Diana Campos,
  • Diana Campos,
  • Ángel Cedillo,
  • Carolina Garcia Vidal,
  • Rodrigo Martino,
  • Carlos Solano,
  • Carlos Solano,
  • Carlos Solano

DOI
https://doi.org/10.3389/fonc.2024.1389345
Journal volume & issue
Vol. 14

Abstract

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IntroductionScarce real-life data exists for COVID-19 management in hematologic disease (HD) patients in the Omicron era.PurposeTo 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.MethodsA 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.ResultsNearly 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.ConclusionsThe 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.

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