Breakthrough COVID-19 in Vaccinated Patients with Haematologic Malignancies—The First Single-Centre Experience from the Czech Republic

Abstract

Vaccination is an important tool in the fight against the COVID-19 pandemic in patients with haematologic malignancies. The paper provides an analysis of the course of breakthrough SARS-CoV-2 infection in a group of vaccinated patients with haematological malignancy and a comparison with a historical cohort of 96 non-vaccinated patients with haematologic malignancies and bone marrow failure syndromes (two patients) in the treatment of COVID-19. A severe or critical course of COVID-19 was significantly less frequent in the group of vaccinated patients (10.2% vs. 31.4%, p = 0.003). The need for hospitalisation due to COVID-19 was significantly lower in vaccinated patients (27.1% vs. 72.6%, p < 0.0001) and the duration of hospitalisation was significantly shorter (10 vs. 14 days, p = 0.045). Vaccinated patients were insignificantly less likely to require oxygen therapy during infection. COVID-19 mortality was significantly higher in non-vaccinated patients (15.6% vs. 5.1%, p = 0.047). The paper demonstrated a significant positive effect of vaccination against COVID-19 on a less severe clinical course of infection, lower need for hospitalisation and mortality. However, the results need to be evaluated even in the context of new antivirals and monoclonal antibodies against SARS-CoV-2 or virus mutations with different biological behaviour.

Vaccine schedule recommendations and updates for patients with hematologic malignancy post‐hematopoietic cell transplant or CAR T‐cell therapy

“…Similarly, instances of overwhelming sepsis secondary to encapsulated organisms, such as Streptococcus pneumoniae or Haemophilus influenzae , have been reported 9–11 . The coronavirus disease 2019 (COVID‐19) pandemic demonstrated how hematology patients, especially those treated with cellular therapies and HCT, are disproportionately affected by infectious diseases that lack adequate prevention strategies, leading to more severe disease, more frequent re‐infections and poorer vaccine response 12–15 …”

“… 9 , 10 , 11 The coronavirus disease 2019 (COVID‐19) pandemic demonstrated how hematology patients, especially those treated with cellular therapies and HCT, are disproportionately affected by infectious diseases that lack adequate prevention strategies, leading to more severe disease, more frequent re‐infections and poorer vaccine response. 12 , 13 , 14 , 15 …”