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

Monia Marchetti; Jon Salmanton-García; Shaimaa El-Ashwah; Luisa Verga; Federico Itri; Zdeněk Ráčil; Julio Dávila-Valls; Sonia Martín-Pérez; Jaap Van Doesum; Francesco Passamonti; Ghaith Abu-Zeinah; Francesca Farina; Alberto López-García; Giulia Dragonetti; Chiara Cattaneo; Maria Gomes Da Silva; Yavuz M Bilgin; Pavel Žák; Verena Petzer; Andreas Glenthøj; Ildefonso Espigado; Caterina Buquicchio; Valentina Bonuomo; Lucia Prezioso; Stef Meers; Rafael Duarte; Rui Bergantim; Ozren Jaksic; Natasha Čolović; Ola Blennow; Martin Cernan; Martin Schönlein; Michail Samarkos; Maria Enza Mitra; Gabriele Magliano; Johan Maertens; Marie-Pierre Ledoux; Moraima Jiménez; Fatih Demirkan; Graham P Collins; Alba Cabirta; Stefanie K Gräfe; Anna Nordlander; Dominik Wolf; Elena Arellano; Raul Cordoba; Michaela Hanakova; Giovanni Paolo Maria Zambrotta; Raquel Nunes Rodrigues; Giulia Limberti; Francesco Marchesi; Oliver A Cornely; Livio Pagano

doi:10.1177/20406207231154706

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

Monia Marchetti, Jon Salmanton-García^*, Shaimaa El-Ashwah, Luisa Verga, Federico Itri, Zdeněk Ráčil, Julio Dávila-Valls, Sonia Martín-Pérez, Jaap Van Doesum, Francesco Passamonti, Ghaith Abu-Zeinah, Francesca Farina, Alberto López-García, Giulia Dragonetti, Chiara Cattaneo, Maria Gomes Da Silva, Yavuz M Bilgin, Pavel Žák, Verena Petzer, Andreas GlenthøjIldefonso Espigado, Caterina Buquicchio, Valentina Bonuomo, Lucia Prezioso, Stef Meers, Rafael Duarte, Rui Bergantim, Ozren Jaksic, Natasha Čolović, Ola Blennow, Martin Cernan, Martin Schönlein, Michail Samarkos, Maria Enza Mitra, Gabriele Magliano, Johan Maertens, Marie-Pierre Ledoux, Moraima Jiménez, Fatih Demirkan, Graham P Collins, Alba Cabirta, Stefanie K Gräfe, Anna Nordlander, Dominik Wolf, Elena Arellano, Raul Cordoba, Michaela Hanakova, Giovanni Paolo Maria Zambrotta, Raquel Nunes Rodrigues, Giulia Limberti, Francesco Marchesi, Oliver A Cornely, Livio Pagano

^*Corresponding author af dette arbejde

Afdeling for Blodsygdomme

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.

Originalsprog	Engelsk
Tidsskrift	Therapeutic advances in hematology
Vol/bind	14
Sider (fra-til)	20406207231154706
ISSN	2040-6207
DOI	https://doi.org/10.1177/20406207231154706
Status	Udgivet - 2023

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10.1177/20406207231154706

Citationsformater

Marchetti, M., Salmanton-García, J., El-Ashwah, S., Verga, L., Itri, F., Ráčil, Z., Dávila-Valls, J., Martín-Pérez, S., Van Doesum, J., Passamonti, F., Abu-Zeinah, G., Farina, F., López-García, A., Dragonetti, G., Cattaneo, C., Gomes Da Silva, M., Bilgin, Y. M., Žák, P., Petzer, V., ... Pagano, L. (2023). Outcomes of SARS-CoV-2 infection in Ph-neg chronic myeloproliferative neoplasms: results from the EPICOVIDEHA registry. Therapeutic advances in hematology, 14, 20406207231154706. https://doi.org/10.1177/20406207231154706

Marchetti, M, Salmanton-García, J, El-Ashwah, S, Verga, L, Itri, F, Ráčil, Z, Dávila-Valls, J, Martín-Pérez, S, Van Doesum, J, Passamonti, F, Abu-Zeinah, G, Farina, F, López-García, A, Dragonetti, G, Cattaneo, C, Gomes Da Silva, M, Bilgin, YM, Žák, P, Petzer, V, Glenthøj, A, Espigado, I, Buquicchio, C, Bonuomo, V, Prezioso, L, Meers, S, Duarte, R, Bergantim, R, Jaksic, O, Čolović, N, Blennow, O, Cernan, M, Schönlein, M, Samarkos, M, Mitra, ME, Magliano, G, Maertens, J, Ledoux, M-P, Jiménez, M, Demirkan, F, Collins, GP, Cabirta, A, Gräfe, SK, Nordlander, A, Wolf, D, Arellano, E, Cordoba, R, Hanakova, M, Zambrotta, GPM, Nunes Rodrigues, R, Limberti, G, Marchesi, F, Cornely, OA & Pagano, L 2023, 'Outcomes of SARS-CoV-2 infection in Ph-neg chronic myeloproliferative neoplasms: results from the EPICOVIDEHA registry', Therapeutic advances in hematology, bind 14, s. 20406207231154706. https://doi.org/10.1177/20406207231154706

@article{eebc917ad05b4023a57865a447f94b95,

title = "Outcomes of SARS-CoV-2 infection in Ph-neg chronic myeloproliferative neoplasms: results from the EPICOVIDEHA registry",

abstract = "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.",

author = "Monia Marchetti and Jon Salmanton-Garc{\'i}a and Shaimaa El-Ashwah and Luisa Verga and Federico Itri and Zden{\v e}k R{\'a}{\v c}il and Julio D{\'a}vila-Valls and Sonia Mart{\'i}n-P{\'e}rez and {Van Doesum}, Jaap and Francesco Passamonti and Ghaith Abu-Zeinah and Francesca Farina and Alberto L{\'o}pez-Garc{\'i}a and Giulia Dragonetti and Chiara Cattaneo and {Gomes Da Silva}, Maria and Bilgin, {Yavuz M} and Pavel {\v Z}{\'a}k and Verena Petzer and Andreas Glenth{\o}j and Ildefonso Espigado and Caterina Buquicchio and Valentina Bonuomo and Lucia Prezioso and Stef Meers and Rafael Duarte and Rui Bergantim and Ozren Jaksic and Natasha {\v C}olovi{\'c} and Ola Blennow and Martin Cernan and Martin Sch{\"o}nlein and Michail Samarkos and Mitra, {Maria Enza} and Gabriele Magliano and Johan Maertens and Marie-Pierre Ledoux and Moraima Jim{\'e}nez and Fatih Demirkan and Collins, {Graham P} and Alba Cabirta and Gr{\"a}fe, {Stefanie K} and Anna Nordlander and Dominik Wolf and Elena Arellano and Raul Cordoba and Michaela Hanakova and Zambrotta, {Giovanni Paolo Maria} and {Nunes Rodrigues}, Raquel and Giulia Limberti and Francesco Marchesi and Cornely, {Oliver A} and Livio Pagano",

note = "{\textcopyright} The Author(s), 2023.",

year = "2023",

doi = "10.1177/20406207231154706",

language = "English",

volume = "14",

pages = "20406207231154706",

journal = "Therapeutic advances in hematology",

issn = "2040-6207",

publisher = "SAGE Publications Inc.",

}

TY - JOUR

T1 - Outcomes of SARS-CoV-2 infection in Ph-neg chronic myeloproliferative neoplasms

T2 - results from the EPICOVIDEHA registry

AU - Marchetti, Monia

AU - Salmanton-García, Jon

AU - El-Ashwah, Shaimaa

AU - Verga, Luisa

AU - Itri, Federico

AU - Ráčil, Zdeněk

AU - Dávila-Valls, Julio

AU - Martín-Pérez, Sonia

AU - Van Doesum, Jaap

AU - Passamonti, Francesco

AU - Abu-Zeinah, Ghaith

AU - Farina, Francesca

AU - López-García, Alberto

AU - Dragonetti, Giulia

AU - Cattaneo, Chiara

AU - Gomes Da Silva, Maria

AU - Bilgin, Yavuz M

AU - Žák, Pavel

AU - Petzer, Verena

AU - Glenthøj, Andreas

AU - Espigado, Ildefonso

AU - Buquicchio, Caterina

AU - Bonuomo, Valentina

AU - Prezioso, Lucia

AU - Meers, Stef

AU - Duarte, Rafael

AU - Bergantim, Rui

AU - Jaksic, Ozren

AU - Čolović, Natasha

AU - Blennow, Ola

AU - Cernan, Martin

AU - Schönlein, Martin

AU - Samarkos, Michail

AU - Mitra, Maria Enza

AU - Magliano, Gabriele

AU - Maertens, Johan

AU - Ledoux, Marie-Pierre

AU - Jiménez, Moraima

AU - Demirkan, Fatih

AU - Collins, Graham P

AU - Cabirta, Alba

AU - Gräfe, Stefanie K

AU - Nordlander, Anna

AU - Wolf, Dominik

AU - Arellano, Elena

AU - Cordoba, Raul

AU - Hanakova, Michaela

AU - Zambrotta, Giovanni Paolo Maria

AU - Nunes Rodrigues, Raquel

AU - Limberti, Giulia

AU - Marchesi, Francesco

AU - Cornely, Oliver A

AU - Pagano, Livio

PY - 2023

Y1 - 2023

N2 - 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.

AB - 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.

U2 - 10.1177/20406207231154706

DO - 10.1177/20406207231154706

M3 - Journal article

C2 - 36923264

VL - 14

SP - 20406207231154706

JO - Therapeutic advances in hematology

JF - Therapeutic advances in hematology

SN - 2040-6207

ER -

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

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