J 2023

Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies: a report from the EPICOVIDEHA registry

SALMANTON-GARCIA, Jon, Francesco MARCHESI, da Silva Maria GOMES, Francesca FARINA, Julio DAVILA-VALLS et. al.

Basic information

Original name

Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies: a report from the EPICOVIDEHA registry

Authors

SALMANTON-GARCIA, Jon, Francesco MARCHESI, da Silva Maria GOMES, Francesca FARINA, Julio DAVILA-VALLS, Yavuz M BILGIN, Andreas GLENTHOJ, Iker FALCES-ROMERO, Van Doesum JAAP, Jorge LABRADOR, Caterina BUQUICCHIO, Shaimaa EL-ASHWAH, Verena PETZER, Van Praet JENS, Martin SCHOENLEIN, Michelina DARGENIO, Gustavo-Adolfo MENDEZ, Stef MEERS, Federico ITRI, Antonio GIORDANO, Laszlo Imre PINCZES, Ildefonso ESPIGADO, Zlate STOJANOSKI, Alberto LOPEZ-GARCIA, Lucia PREZIOSO, Ozren JAKSIC, Antonio VENA, Nicola S FRACCHIOLLA, Tomas Jose GONZALEZ-LOPEZ, Natasa COLOVIC, Mario DELIA, Barbora WEINBERGEROVÁ (203 Czech Republic, belonging to the institution), Monia MARCHETTI, de Almeida Joyce MARQUES, Olimpia FINIZIO, Caroline BESSON, Monika M BIERNAT, Toni VALKOVIC, Tobias LAHMER, Annarosa CUCCARO, Irati ORMAZABAL-VELEZ, Josip BATINIC, Noemi FERNANDEZ, De Jonge NICK, Carlo TASCINI, Amalia N ANASTASOPOULOU, Remy DULERY, Del Principe Maria ILARIA, Gaetan PLANTEFEVE, Mario Virgilio PAPA, Marcio NUCCI, Moraima JIMENEZ, Avinash AUJAYEB, Jose-angel HERNANDEZ-RIVAS, Maria MERELLI, Chiara CATTANEO, Ola BLENNOW, Anna NORDLANDER, Alba CABIRTA, Gina VARRICCHIO, Maria Vittoria SACCHI, Raul CORDOBA, Elena ARELLANO, Stefanie K GRAFE, Dominik WOLF, Ziad EMARAH, Emanuele AMMATUNA, Ditte Stampe HERSBY, Sonia MARTIN-PEREZ, Raquel Nunes RODRIGUES, Laman RAHIMLI, Livio PAGANO and Oliver A CARTNEY

Edition

EClinicalMedicine, AMSTERDAM, ELSEVIER, 2023, 2589-5370

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30205 Hematology

Country of publisher

Netherlands

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 15.100 in 2022

RIV identification code

RIV/00216224:14110/23:00133408

Organization unit

Faculty of Medicine

UT WoS

000999279400001

Keywords in English

Nirmatrelvir; SARS-CoV-2; Haematology; Malignancy; COVID-19

Tags

Tags

International impact, Reviewed
Změněno: 2/2/2024 10:05, Mgr. Tereza Miškechová

Abstract

V originále

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 pa-tients 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 Asso-ciated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223). Copyright (c) 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).