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Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies: a report from the EPICOVIDEHA registry
J. Salmanton-García, F. Marchesi, M. Gomes da Silva, F. Farina, J. Dávila-Valls, YM. Bilgin, A. Glenthøj, I. Falces-Romero, J. Van Doesum, J. Labrador, C. Buquicchio, S. El-Ashwah, V. Petzer, J. Van Praet, M. Schönlein, M. Dargenio, GA. Méndez,...
Status neindexováno Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články
NLK
Directory of Open Access Journals
od 2018
PubMed Central
od 2018
Europe PubMed Central
od 2018
ROAD: Directory of Open Access Scholarly Resources
od 2018
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Nirmatrelvir/ritonavir treatment decreases the hospitalisation rate in immunocompetent patients with COVID-19, but data on efficacy in patients with haematological malignancy are scarce. Here, we describe the outcome of nirmatrelvir/ritonavir treatment in a large cohort of the latter patients. METHODS: This is a retrospective cohort study from the multicentre EPICOVIDEHA registry (NCT04733729) on patients with haematological malignancy, who were diagnosed with COVID-19 between January and September 2022. Patients receiving nirmatrelvir/ritonavir were compared to those who did not. A logistic regression was run to determine factors associated with nirmatrelvir/ritonavir administration in our sample. Mortality between treatment groups was assessed with Kaplan-Meier survival plots after matching all the patients with a propensity score. Additionally, a Cox regression was modelled to detect factors associated with mortality in patients receiving nirmatrelvir/ritonavir. FINDINGS: A total of 1859 patients were analysed, 117 (6%) were treated with nirmatrelvir/ritonavir, 1742 (94%) were treated otherwise. Of 117 patients receiving nirmatrelvir/ritonavir, 80% had received ≥1 anti-SARS-CoV-2 vaccine dose before COVID-19 onset, 13% of which received a 2nd vaccine booster. 5% were admitted to ICU. Nirmatrelvir/ritonavir treatment was associated with the presence of extrapulmonary symptoms at COVID-19 onset, for example anosmia, fever, rhinitis, or sinusitis (aOR 2.509, 95%CI 1.448-4.347) and 2nd vaccine booster (aOR 3.624, 95%CI 1.619-8.109). Chronic pulmonary disease (aOR 0.261, 95%CI 0.093-0.732) and obesity (aOR 0.105, 95%CI 0.014-0.776) were not associated with nirmatrelvir/ritonavir use. After propensity score matching, day-30 mortality rate in patients treated with nirmatrelvir/ritonavir was 2%, significantly lower than in patients with SARS-CoV-2 directed treatment other than nirmatrelvir/ritonavir (11%, p = 0.036). No factor was observed explaining the mortality difference in patients after nirmatrelvir/ritonavir administration. INTERPRETATION: Haematological malignancy patients were more likely to receive nirmatrelvir/ritonavir when reporting extrapulmonary symptoms or 2nd vaccine booster at COVID-19 onset, as opposed to chronic pulmonary disease and obesity. The mortality rate in patients treated with nirmatrelvir/ritonavir was lower than in patients with targeted drugs other than nirmatrelvir/ritonavir. FUNDING: EPICOVIDEHA has received funds from Optics COMMIT (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223).
1 Department of Medicine University Medical Center Hamburg Eppendorf Hamburg Germany
3 Department of Medicine University Medical Center Hamburg Eppendorf Hamburg Germany
Amsterdam UMC Location VUmc Amsterdam the Netherlands
Azienda Ospedaliera Nazionale SS Antonio e Biagio e Cesare Arrigo Alessandria Italy
Azienda Ospedaliera Sant'Anna e San Sebastiano Caserta Italy
Azienda Sanitaria Universitaria del Friuli Centrale Udine Italy
Centre Hospitalier de Versailles Le Chesnay France
CIBERINFEC Instituto de Salud Carlos 3 Madrid Spain
Complejo Hospitalario de Navarra Iruña Pamplona Spain
Croatian Cooperative Group for Hematological Diseases Croatia
Departament de Medicina Universitat Autònoma de Barcelona Bellaterra Spain
Department of Hematology and Oncology Comprehensive Cancer Center Innsbruck Innsbruck Austria
Department of Hematology Copenhagen University Hospital Rigshospitalet Copenhagen Denmark
Department of Hematology Hospital Universitario de Burgos Burgos Spain
Department of Hematology Research Unit Hospital Universitario de Burgos Burgos Spain
Department of Hematology University Hospital Dubrava Zagreb Croatia
Department of Hematology University Hospital Virgen Macarena Seville Spain
Department of Infectious Diseases Karolinska University Hospital Stockholm Sweden
Department of Internal Medicine ADRZ Goes the Netherlands
Department of Nephrology and Infectious Diseases AZ Sint Jan Brugge Oostende AV Brugge Belgium
Departmento de Medicina Universidad Complutense de Madrid Madrid Spain
Ematologia con Trapianto Ospedale Dimiccoli Barletta Barletta Italy
Facultad de Ciencias de la Salud Universidad Isabel 1 Burgos Spain
Faculty of Medicine and Faculty of Health Studies University of Rijeka Rijeka Croatia
Federal University of Rio de Janeiro Rio de Janeiro Brazil
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan Italy
Fundacion Jimenez Diaz University Hospital Health Research Institute IIS FJD Madrid Spain
German Centre for Infection Research Partner Site Bonn Cologne Cologne Germany
Head ICU and CRC Centre Hospitalier Victor DUPOUY Argenteuil France
Hematology and Stem Cell Transplant Unit IRCCS Regina Elena National Cancer Institute Rome Italy
Hematology and Stem Cell Transplant Unit Vito Fazzi Lecce Italy
Hematology and Stem Cell Transplantation Unit AOUC Policlinico Bari Italy
Hematology Department of Biomedicine and Prevention University of Rome Tor Vergata Rome Italy
Hematology Unit ASST Spedali Civili Brescia Italy
Hematology Unit Center for Translational Medicine Azienda USL Toscana NordOvest Livorno Italy
Hematology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy
Hematology Unit Università Cattolica del Sacro Cuore Rome Italy
Hospital Escuela de Agudos Dr Ramón Madariaga Posadas Argentina
Hospital Nuestra Señora de Sonsoles Ávila Spain
Hospital Universitario Infanta Leonor Madrid Spain
Hospital Universitario Marqués de Valdecilla Santander Spain
Hospital University of Parma Hematology and Bone Marrow Unit Parma Italy
IRCCS Ospedale San Raffaele Milan Italy
Istituto Oncologico della Svizzera Italiana Bellinzona Switzerland
La Paz University Hospital Madrid Spain
Laikon Hospital Medical School National and Kapodistrian University of Athens Athens Greece
Medizinische Klinik 2 Klinikum rechts der Isar TU München Munich Germany
Northumbria Healthcare Newcastle United Kingdom
Oncology Center Mansoura University Mansoura Egypt
Ospedale Policlinico San Martino Genoa Italy
Portuguese Institute of Oncology Lisbon Portugal
San Luigi Gonzaga Hospital Orbassano Orbassano Italy
School of Medicine University of Zagreb Zagreb Croatia
Université Paris Saclay UVSQ Inserm Équipe Exposome et Hérédité CESP Villejuif France
University Clinic of Hematology Skopje North Macedonia
University Clinical Center Serbia Medical Faculty University Belgrade Belgrade Serbia
University Hospital Centre Rijeka Rijeka Croatia
University Hospital Centre Zagreb Zagreb Croatia
University Medical Center Groningen Groningen the Netherlands
Citace poskytuje Crossref.org
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