Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies: a report from the EPICOVIDEHA registry
- Creators
- Salmanton-García, Jon
- Marchesi, Francesco
- Gomes da Silva, Maria
- Farina, Francesca
- Dávila-Valls, Julio
- Bilgin, Yavuz M
- Glenthøj, Andreas
- Falces-Romero, Iker
- Van Doesum, Jaap
- Labrador, Jorge
- Buquicchio, Caterina
- El-Ashwah, Shaimaa
- Petzer, Verena
- Van Praet, Jens
- Schönlein, Martin
- Dargenio, Michelina
- Méndez, Gustavo-Adolfo
- Meers, Stef
- Itri, Federico
- Giordano, Antonio
- Pinczés, László Imre
- Espigado, Ildefonso
- Stojanoski, Zlate
- López-García, Alberto
- Prezioso, Lucia
- Jaksic, Ozren
- Vena, Antonio
- Fracchiolla, Nicola S
- González-López, Tomás José
- Colović, Natasa
- Delia, Mario
- Weinbergerová, Barbora
- Marchetti, Monia
- Marques de Almeida, Joyce
- Finizio, Olimpia
- Besson, Caroline
- Biernat, Monika M
- Valković, Toni
- Lahmer, Tobias
- Cuccaro, Annarosa
- Ormazabal-Vélez, Irati
- Batinić, Josip
- Fernández, Noemí
- De Jonge, Nick
- Tascini, Carlo
- Anastasopoulou, Amalia N
- Duléry, Rémy
- Del Principe, Maria Ilaria
- Plantefeve, Gaëtan
- Papa, Mario Virgilio
- Nucci, Marcio
- Jiménez, Moraima
- Aujayeb, Avinash
- Hernández-Rivas, José-Ángel
- Merelli, Maria
- Cattaneo, Chiara
- Blennow, Ola
- Nordlander, Anna
- Cabirta, Alba
- Varricchio, Gina
- Sacchi, Maria Vittoria
- Cordoba, Raul
- Arellano, Elena
- Gräfe, Stefanie K
- Wolf, Dominik
- Emarah, Ziad
- Ammatuna, Emanuele
- Hersby, Ditte Stampe
- Martín-Pérez, Sonia
- Nunes Rodrigues, Raquel
- Rahimli, Laman
- Pagano, Livio
- Cornely, Oliver A
- Others:
- Salmanton-García, Jon
- Marchesi, Francesco
- Gomes da Silva, Maria
- Farina, Francesca
- Dávila-Valls, Julio
- Bilgin, Yavuz M
- Glenthøj, Andrea
- Falces-Romero, Iker
- Van Doesum, Jaap
- Labrador, Jorge
- Buquicchio, Caterina
- El-Ashwah, Shaimaa
- Petzer, Verena
- Van Praet, Jen
- Schönlein, Martin
- Dargenio, Michelina
- Méndez, Gustavo-Adolfo
- Meers, Stef
- Itri, Federico
- Giordano, Antonio
- Pinczés, László Imre
- Espigado, Ildefonso
- Stojanoski, Zlate
- López-García, Alberto
- Prezioso, Lucia
- Jaksic, Ozren
- Vena, Antonio
- Fracchiolla, Nicola S
- González-López, Tomás José
- Colović, Natasa
- Delia, Mario
- Weinbergerová, Barbora
- Marchetti, Monia
- Marques de Almeida, Joyce
- Finizio, Olimpia
- Besson, Caroline
- Biernat, Monika M
- Valković, Toni
- Lahmer, Tobia
- Cuccaro, Annarosa
- Ormazabal-Vélez, Irati
- Batinić, Josip
- Fernández, Noemí
- De Jonge, Nick
- Tascini, Carlo
- Anastasopoulou, Amalia N
- Duléry, Rémy
- Del Principe, Maria Ilaria
- Plantefeve, Gaëtan
- Papa, Mario Virgilio
- Nucci, Marcio
- Jiménez, Moraima
- Aujayeb, Avinash
- Hernández-Rivas, José-Ángel
- Merelli, Maria
- Cattaneo, Chiara
- Blennow, Ola
- Nordlander, Anna
- Cabirta, Alba
- Varricchio, Gina
- Sacchi, Maria Vittoria
- Cordoba, Raul
- Arellano, Elena
- Gräfe, Stefanie K
- Wolf, Dominik
- Emarah, Ziad
- Ammatuna, Emanuele
- Hersby, Ditte Stampe
- Martín-Pérez, Sonia
- Nunes Rodrigues, Raquel
- Rahimli, Laman
- Pagano, Livio
- Cornely, Oliver A
Description
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).
Additional details
- URL
- https://hdl.handle.net/11567/1123555
- URN
- urn:oai:iris.unige.it:11567/1123555
- Origin repository
- UNIGE