Dexamethasone treatment for COVID-19 is related to increased mortality in hematologic malignancy patients: results from the EPICOVIDEHA registry

The optimal treatment strategies for hematological malignancy patients with COVID19 are still unclear with respect to the selection and timing of anti-viral as well as anti-inflammatory therapies. Most COVID-19 management recommendations have been adapted from the ones used in immunocompetent patien...

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Detalhes bibliográficos
Autores: Aiello, Tommaso Francesco, Salmanton-García, Jon, Marchesi, Francesco, Weinbergerová, Barbora, Glenthøj, Andreas, Van Praet, Jens, Espigado Tocino, Ildefonso, Pagano, Livio
Tipo de documento: artigo
Estado:Versão publicada
Data de publicação:2024
País:España
Recursos:Universidad de Sevilla (US)
Repositório:idUS. Depósito de Investigación de la Universidad de Sevilla
OAI Identifier:oai:idus.us.es:11441/175614
Acesso em linha:https://hdl.handle.net/11441/175614
https://doi.org/10.3324/haematol.2023.284678
Access Level:Acceso aberto
Palavra-chave:COVID19
Hematological malignancy
Anti-inflammatory therapies
Immunosuppressed patients
Dexamethasone treatment
SARS-CoV-2 infection
Vaccines
Descrição
Resumo:The optimal treatment strategies for hematological malignancy patients with COVID19 are still unclear with respect to the selection and timing of anti-viral as well as anti-inflammatory therapies. Most COVID-19 management recommendations have been adapted from the ones used in immunocompetent patients. However, immunosuppressed patients often have substantial alterations in their adaptive and innate immunity that affect the pathophysiology of SARS-CoV-2 infection and often have reduced anti-viral immunity as well as dysfunctional inflammatory response. As a result, we hypothesize that these patients mainly benefit more from antiviral treatment, whereas dexamethasone may perpetuate the intrinsic immunosuppression and be even detrimental. Our study demonstrates that dexamethasone treatment for SARS-CoV-2 infection is related to increased mortality in hematological malignancy patients, even during the omicron wave with most patients being fully vaccinated.