Outcomes of SARS-CoV-2 infection in Ph-neg chronic myeloproliferative neoplasms: results from the EPICOVIDEHA registry.

Autor:	Marchetti M; Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy., Salmanton-García J; Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany., El-Ashwah S; Oncology Center, Mansoura University, Mansoura, Egypt., Verga L; Azienda Ospedaliera San Gerardo-Monza, Monza, Italy; Università Milano-Bicocca, Milan, Italy., Itri F; San Luigi Gonzaga Hospital-Orbassano, Orbassano, Italy., Ráčil Z; Institute of Hematology and Blood Transfusion, Prague, Czech Republic., Dávila-Valls J; Hospital Nuestra Señora de Sonsoles, Ávila, Spain., Martín-Pérez S; Hospital Nuestra Señora de Sonsoles, Ávila, Spain., Van Doesum J; University Medical Center Groningen, Groningen, The Netherlands., Passamonti F; University Insubria, Varese, Italy., Abu-Zeinah G; Division of Hematology and Oncology, Weill Cornell Medicine, New York, NY, USA., Farina F; IRCCS Ospedale San Raffaele, Milan, Italy., López-García A; Health Research Institute IIS-FJD, Fundación Jimenez Diaz University Hospital, Madrid, Spain., Dragonetti G; Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Rome, Italy., Cattaneo C; Hematology Unit, ASST-Spedali Civili, Brescia, Italy., Gomes Da Silva M; Portuguese Institute of Oncology, Lisbon, Portugal., Bilgin YM; Department of Internal Medicine, ADRZ, Goes, The Netherlands., Žák P; University Hospital Hradec Králové, Hradec Králové, Czech Republic., Petzer V; Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria., Glenthøj A; Department of Hematology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark., Espigado I; Department of Hematology, University Hospital Virgen Macarena-University Hospital Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBIS/CSIC) and Departamento de Medicina, Universidad de Sevilla, Seville, Spain., Buquicchio C; Ematologia con Trapianto, Ospedale Dimiccoli Barletta, Barletta, Italy., Bonuomo V; Section of Hematology, Department of Medicine, University of Verona, Verona, Italy., Prezioso L; Hematology and Bone Marrow Unit, Hospital University of Parma, Parma, Italy., Meers S; AZ KLINA, Brasschaat, Belgium., Duarte R; Hospital Universitario Puerta de Hierro, Majadahonda, Spain., Bergantim R; Centro Hospitalar e Universitário São João, Porto, Portugal., Jaksic O; University Hospital Dubrava, Zagreb, Croatia., Čolović N; University Clinical Center Serbia, Medical Faculty University Belgrade, Belgrade, Serbia., Blennow O; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden., Cernan M; University Hospital Olomouc, Olomouc, Czech Republic., Schönlein M; Department of Oncology, Hematology and Bone Marrow Transplantation with Section of Pneumology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Samarkos M; Laikon Hospital, Athens, Greece., Mitra ME; UO Ematologia, AOUP P. Giaccone, Palermo, Italy., Magliano G; ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy., Maertens J; KU Leuven, Leuven, Belgium., Ledoux MP; ICANS, Strasbourg, France., Jiménez M; Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.; Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain., Demirkan F; Division of Hematology, Dokuz Eylul University, Izmir, Turkey., Collins GP; NIHR Oxford Biomedical Research Centre, Churchill Hospital, Oxford, UK., Cabirta A; Department of Hematology, Vall d'Hebron Hospital Universitari, Experimental Hematology, Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain.; Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain., Gräfe SK; Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.; Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany., Nordlander A; Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden., Wolf D; Department of Hematology and Oncology, Medical University of Innsbruck, Innsbruck, Austria., Arellano E; Department of Hematology, University Hospital Virgen Macarena, Seville, Spain., Cordoba R; Health Research Institute IIS-FJD, Fundacion Jimenez Diaz University Hospital, Madrid, Spain., Hanakova M; Institute of Hematology and Blood Transfusion, Prague, Czech Republic., Zambrotta GPM; Azienda Ospedaliera San Gerardo-Monza, Monza, Italy; Università Milano-Bicocca, Milan, Italy., Nunes Rodrigues R; Portuguese Institute of Oncology, Lisbon, Portugal., Limberti G; Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy., Marchesi F; Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy., Cornely OA; Department I of Internal Medicine, Excellence Center for Medical Mycology (ECMM), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.; Chair Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.; Clinical Trials Centre Cologne (ZKS Köln), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.; Center for Molecular Medicine Cologne (CMMC), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.; German Centre for Infection Research (DZIF), Partner Site Bonn-Cologne, Cologne, Germany., Pagano L; Hematology Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, Rome, Italy.; Hematology Unit, Università Cattolica del Sacro Cuore, Rome, Italy.
Jazyk:	angličtina
Zdroj:	Therapeutic advances in hematology [Ther Adv Hematol] 2023 Mar 11; Vol. 14, pp. 20406207231154706. Date of Electronic Publication: 2023 Mar 11 (Print Publication: 2023).
DOI:	10.1177/20406207231154706
Abstrakt:	Background: Patients with Philadelphia-negative chronic myeloproliferative neoplasms (MPN) typically incur high rates of infections and both drugs and comorbidities may modulate infection risk. Objectives: The present study aims to assess the effect of immunosuppressive agents on clinical outcomes of MPN patients affected by the coronavirus disease 2019 (COVID-19). Design: This is an observational study. Methods: We specifically searched and analyzed MPN patients collected by EPICOVIDEHA online registry, which includes individuals with hematological malignancies diagnosed with COVID-19 since February 2020. Results: Overall, 398 patients with MPN were observed for a median of 76 days [interquartile range (IQR): 19-197] after detection of SARS-CoV2 infection. Median age was 69 years (IQR: 58-77) and 183 individuals (46%) had myelofibrosis (MF). Overall, 121 patients (30%) of the whole cohort received immunosuppressive therapies including steroids, immunomodulatory drugs, or JAK inhibitors. Hospitalization and consecutive admission to intensive care unit was required in 216 (54%) and 53 patients (13%), respectively. Risk factors for hospital admission were identified by multivariable logistic regression and include exposure to immunosuppressive therapies [odds ratio (OR): 2.186; 95% confidence interval (CI): 1.357-3.519], age ⩾70 years, and comorbidities. The fatality rate was 22% overall and the risk of death was independently increased by age ⩾70 years [hazard ratio (HR): 2.191; 95% CI: 1.363-3.521], previous comorbidities, and exposure to immunosuppressive therapies before the infection (HR: 2.143; 95% CI: 1.363-3.521). Conclusion: COVID-19 infection led to a particularly dismal outcome in MPN patients receiving immunosuppressive agents or reporting multiple comorbidities. Therefore, specific preventive strategies need to be tailored for such individuals. Plain Language Summary: EPICOVIDEHA registry reports inferior outcomes of COVID-19 in patients with Philadelphia-negative chronic myeloproliferative neoplasms receiving immunosuppressive therapies. Patients with Philadelphia-negative chronic myeloproliferative neoplasms (MPN) incur high rates of infections during the course of their disease.The present study was aimed at assessing which patient characteristics predicted a worse outcome of SARS-COV-2 infection in individuals with MPN.To pursue this objective, the researchers analyzed the data collected by EPICOVIDEHA, an international online registry, which includes individuals with hematological malignancies diagnosed with COVID-19 since February 2020.The database provided clinical data of 398 patients with MPN incurring COVID-19:Patients were mostly elderly (median age was 69 years);Forty-six percent of them were affected by myelofibrosis, which is the most severe MPN;Moreover, 32% were receiving immunosuppressive therapies (JAK inhibitors, such as ruxolitinib, steroids, or immunomodulatory IMID drugs, such as thalidomide) before COVID-19.Hospitalization was required in 54% of the patients, and the risk of being hospitalized for severe COVID-19 was independently predicted byOlder age;Comorbidities;Exposure to immunosuppressive therapies.Overall, 22% of MPN patients deceased soon after COVID-19 and the risk of death was independently increased over twofold byOlder age;Comorbidities;Exposure to immunosuppressive therapies before the infection.In conclusion, COVID-19 infection led to a particularly dismal outcome in MPN patients receiving immunosuppressive agents, including JAK inhibitors, or reporting multiple comorbidities. Therefore, specific preventive strategies need to be tailored for such individuals. Competing Interests: The author declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: JSG reports speaker honoraria from Gilead and Pfizer, outside of the submitted work. DW received speakers honorary and research funding from Novartis, AOP Pharma, Incyte, Bexxalta, BMS/Celgene, outside of the submitted work. MM received consultancy fees from Gilead, outside of the submitted work. OAC reports grants or contracts from Amplyx, Basilea, BMBF, Cidara, DZIF, EU-DG RTD (101037867), F2G, Gilead, Matinas, MedPace, MSD, Mundipharma, Octapharma, Pfizer, Scynexis; Consulting fees from Abbvie, Amplyx, Biocon, Biosys, Cidara, Da Volterra, Gilead, Matinas, MedPace, Menarini, Molecular Partners, MSG-ERC, Noxxon, Octapharma, Pardes, PSI, Scynexis, Seres; Honoraria for lectures from Abbott, Al-Jazeera Pharmaceuticals, Astellas, Grupo Biotoscana/United Medical/Knight, Hikma, MedScape, MedUpdate, Merck/MSD, Mylan, Pfizer; Payment for expert testimony from Cidara; Participation on a Data Safety Monitoring Board or Advisory Board from Actelion, Allecra, Cidara, Entasis, IQVIA, Janssen, MedPace, Paratek, PSI, Pulmocide, Shionogi; A patent at the German Patent and Trade Mark Office (DE 10 2021 113 007.7), outside of the submitted work. No relevant conflicts of interest are reported by all the other authors. (© The Author(s), 2023.)
Databáze:	MEDLINE
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