Low mortality in vaccinated immunocompromised haematology patients infected with SARS‐CoV‐2

Abstract

Coronavirus disease 2019 (COVID-19) infection in patients with haematological neoplasms has been associated with increased mortality; however, many studies in this patient group were reported early in the pandemic. The authors evaluated outcomes of COVID-19 infection in patients with haematological conditions following widespread vaccination, newer viral variants and increasingly effective antiviral therapies. A 4% mortality rate was found and contemporary risk factors for hospitalisation including older age, nonvaccination or partial COVID-19 vaccination status and infection with non-Omicron strain were identified.

High prevalence of persistent COVID‐19‐related health anxiety and social restriction in patients with haematological disorders

“…[10][11][12] In 2020, the introduction of precautionary social restriction was paramount to reducing risk, and measures were shown to reduce anxiety by decreasing fear of contracting. 13 We 5 and others 4 have shown that the absolute risks have since declined considerably in haematology patients. Yet, in our cohort, half of the patients had at least one ongoing behavioural change.…”

“…Patients with haematological disorders were realised to be a highly vulnerable group 1,2 and were encouraged to shield and restrict social contact. However, widespread vaccination and the reduced pathogenicity of the more recent Omicron strain have greatly reduced the mortality 3,4 and morbidity, 5 even in haematology patients. As such, in the United Kingdom, national guidance on lockdowns and social distancing has returned to the pre-COVID-19 paradigm.…”

High risk of infection in ‘real‐world’ patients receiving ibrutinib, idelalisib or venetoclax for mature B‐cell leukaemia/lymphoma

“…Single centre, retrospective cohort study across five sites of a tertiary‐level hospital network serving a patient population catchment of 1.5 million in the Australian state of Victoria. Following institutional human research ethics committee approval, pharmacy electronic dispensing records were filtered to identify all patients who had received ibrutinib, idelalisib or venetoclax since October 2014 until June 2021 (which predates widespread community transmission of Sars‐Cov‐2 in Victoria) 23 . Electronic medical records were reviewed for patient demographic data, baseline Eastern Cooperative Oncology Group (ECOG) performance status and Charlson Comorbidity Index (CCI) score, treatment exposure and history and baseline antimicrobial prophylaxis usage.…”

“…Following institutional human research ethics committee approval, pharmacy electronic dispensing records were filtered to identify all patients who had received ibrutinib, idelalisib or venetoclax since October 2014 until June 2021 (which predates widespread community transmission of Sars‐Cov‐2 in Victoria). 23 Electronic medical records were reviewed for patient demographic data, baseline Eastern Cooperative Oncology Group (ECOG) performance status and Charlson Comorbidity Index (CCI) score, treatment exposure and history and baseline antimicrobial prophylaxis usage. Electronic pathology records were accessed to define baseline serum immunoglobulin G (IgG) levels, serological findings for hepatitis B, human immunodeficiency virus (HIV) and cytomegalovirus (CMV), and evidence of latent tuberculosis (TB) infection.…”

Comparable cellular and humoral immunity upon homologous and heterologous COVID-19 vaccination regimens in kidney transplant recipients

“…Second, other arms of the adaptive immune response are not always considered, and the emerging data so far show an inconsistent picture (17)(18)(19). Due to the lower response to the vaccine, more severe courses of COVID-19 and increased mortality are currently found in immunosuppressed patients, even if the overall mortality has been significantly lower as compared to the infection with the delta variant (20)(21)(22).…”