COVID-19 in patients with haematologic malignancies: Effect of RNAemia on clinical outcome in vaccinated patients

Objectives: Patients with haematologic malignancies (HM) COVID-19 have more severe disease, with increased risk of mortality. Therefore, this study aimed to evaluate the effect of SARS-CoV-2 RNAemia and the specific humoral immune responses on the clinical outcomes of patients with HM and COVID-19....

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Detalles Bibliográficos
Autores: Martín-Escolano, Rubén, Salto-Alejandre, Sonsoles, Infante-Domínguez, Carmen, Carretero-Ledesma, Marta, Maldonado Lizarazo, Natalia Andrea, Camacho-Martínez, Pedro, Pérez-Palacios, Patricia, Cisneros, José Miguel, Cordero Matia, María Elisa, Pachón Díaz, Jerónimo, Pérez Simón, José Antonio, Sánchez Céspedes, Javier, Aguilar Guisado, Manuela
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Universidad de Sevilla (US)
Repositorio:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/180540
Acceso en línea:https://hdl.handle.net/11441/180540
https://doi.org/10.1016/j.ijid.2024.107163
Access Level:acceso abierto
Palabra clave:COVID-19
SARS-CoV-2
RNAemia
Haematologic malignancies
Clinical outcome
Descripción
Sumario:Objectives: Patients with haematologic malignancies (HM) COVID-19 have more severe disease, with increased risk of mortality. Therefore, this study aimed to evaluate the effect of SARS-CoV-2 RNAemia and the specific humoral immune responses on the clinical outcomes of patients with HM and COVID-19. Methods: Interferon-α/γ (IFN-α/IFN-γ) serum levels, neutralizing antibodies and RNAemia at COVID-19 diagnosis, and persistent RNAemia during the follow-up were evaluated. Results: Overall, 63 (58.9%) out of 107 patients had RNAemia, which was persistent in 26 (41.3%) patients. RNAemia at diagnosis and persistent RNAemia were associated with the need for high-flow nasal oxygen therapy during admission. Persistent RNAemia, age >70 years, and CURB-65 score ≥2 in patients with pneumonia were associated with increased 90-day mortality (P = 0.009, P = 0.030 and P = 0.001, respectively). The 90-day overall survival was lower (P = 0.006) in patients with persistent RNAemia. In addition, dexamethasone administration was associated with a COVID-19 episode with persistent RNAemia. Conclusion: Our results suggest that in patients with HM, RNAemia at the time of COVID-19 diagnosis and during the follow-up can be used to stratify patients with HM according to their clinical evolution and to guide clinical decisions tailored to the specific needs of each patient.

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