Second versus first wave of COVID-19 in patients with MPN

Abstract

TO THE EDITORThe first wave of the SARS-CoV-2 coronavirus disease 2019 began in January 2020, affecting many European countries and leading to an overwhelming of the capacity of acute care hospitals and intensive care units (ICUs). Patients with hematologic malignancies incurring COVID-19 were among the most vulnerable [1-3] and in those with myeloproliferative neoplasms (MPN) including essential thrombocythemia (ET), polycythemia vera (PV), prefibrotic myelofibrosis (pre-PMF) and myelofibrosis (MF), deaths were registered in 28% of cases, being particularly elevated in MF (48%). Age, male gender, admission to ICU, severity of COVID-19 and ruxolitinib discontinuation at COVID-19 diagnosis were independent risk factors for death [4].The pandemic substantially subsided in Europe until October 2020, likely due to non-pharmaceutical control measures including wearing of a mask, hand washing, social distancing, quarantine and city/region lockdown. These interventions gradually relaxed in consideration of the trade-off between economic sustainability and public health, leading to a second wave of infection, also triggered by new SARS-CoV-2 variants. These raised concerns and uncertainties regarding a possibly new clinical epidemiology of the new virus variants in terms of presentation, severity of acute infection and clinical outcomes.In the present analysis, we report the outcomes recorded in the 12 months after the first wave declined, pursuing a dual purpose: (i) to describe possible differences of COVID-19 presentation between the two waves and (ii) to evaluate the rate and risk factors of relevant outcomes, including mortality, thrombosis and main clinical events in MPN patients surviving after the acute phase of COVID-19.The MPN-COVID study is steadily enrolling consecutive adult MPN patients with COVID-19 infection since February 15, 2020. Thirty-nine hematologic centers from Italy,

Determinants of Covid19 disease and of survival after Covid19 in MPN patients treated with ruxolitinib

“…The incidence did not change significantly in the three waves. This confirms previous reports on MPN patients [ 12 ] and probably reflects the rapid administration of vaccines in these oncological patients, with reduced spread of the most infectious variants. Indeed, only vaccination status could significantly reduce the risk of infection in this cohort.…”

Determinants of early triage for hospitalization in myeloproliferative neoplasm (MPN) patients with COVID‐19

“…Details of protocol design and operational procedures have already been reported. 1 , 2 Waves of the COVID‐19 pandemic were divided into two periods, according to the type of predominant circulating VOCs in Europe. The first wave, corresponding to wild type variant, covered the period from February 15 to June 30, 2020; the second wave, started from July 1, 2020 to June 30, 2021 included the alpha, beta, and gamma VOCs infection.…”

Early Cellular and Humoral Responses Developed in Oncohematological Patients after Vaccination with One Dose against COVID-19

“…However, booster doses with mRNA vaccines have shown to be effective at inducing high neutralizing titers in immunocompetent patients [ 56 ] and seem to be able to avoid severe illness even though breakthrough infections may be common. Moreover, mortality in OHD individuals appears to be decreasing through the consecutive waves [ 57 ], which may be related to increasing numbers of patients with partial or complete vaccination schedules.…”