Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies: a report from the EPICOVIDEHA registry

J. Salmanton-Garcia; F. Marchesi; da Silva M. Gomes; F. Farina; J. Davila-Valls; Y. M. Bilgin; A. Glenthoj; I. Falces-Romero; Doesum J. Van; J. Labrador; C. Buquicchio; S. El-Ashwah; V. Petzer; Praet J. Van; M. Schonlein; M. Dargenio; Mendez G. -A.; S. Meers; F. Itri; A. Giordano; L. I. Pinczes; I. Espigado; Z. Stojanoski; A. Lopez-Garcia; L. Prezioso; O. Jaksic; A. Vena; N. S. Fracchiolla; T. J. Gonzalez-Lopez; N. Colovic; M. Delia; B. Weinbergerova; M. Marchetti; de Almeida J. Marques; O. Finizio; C. Besson; M. M. Biernat; T. Valkovic; T. Lahmer; A. Cuccaro; I. Ormazabal-Velez; J. Batinic; N. Fernandez; Jonge N. De; C. Tascini; A. N. Anastasopoulou; R. Dulery; Principe M. I. Del; G. Plantefeve; M. V. Papa; M. Nucci; M. Jimenez; A. Aujayeb; Hernandez-Rivas J. -A.; M. Merelli; C. Cattaneo; O. Blennow; A. Nordlander; A. Cabirta; G. Varricchio; M. V. Sacchi; R. Cordoba; E. Arellano; S. K. Grafe; D. Wolf; Z. Emarah; E. Ammatuna; D. S. Hersby; S. Martin-Perez; Rodrigues R. Nunes; L. Rahimli; Livio Pagano; O. A. Cornely; K. Piukovics; Ramon C. De; F. Danion; A. Yahya; A. Guidetti; C. Garcia-Vidal; U. Sili; J. Meletiadis; Kort E. De; L. Verga; L. Serrano; N. Erben; Blasi R. Di; A. Tragiannidis; Ribera-Santa Susana J. -M.; Ommen H. -B.; A. Busca; N. Coppola; R. Bergantim; G. Dragonetti; M. Criscuolo; Luana Fianchi; M. Bonanni; A. Soto-Silva; M. Mikulska; M. Machado; Kho C. Shan; N. Hassan; E. Gavriilaki; G. Cordini; L. Y. A. Chi; M. Eggerer; M. Hoenigl; J. Prattes; Jimenez-Lorenzo M. -J.; S. Zompi; G. P. M. Zambrotta; G. M. Colak; N. Garcia-Pouton; T. F. Aiello; R. Prin; M. Stamouli; M. Samarkos

doi:10.1016/j.eclinm.2023.101939

Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies: a report from the EPICOVIDEHA registry

J. Salmanton-Garcia^*, F. Marchesi, da Silva M. Gomes, F. Farina, J. Davila-Valls, Y. M. Bilgin, A. Glenthoj, I. Falces-Romero, Doesum J. Van, J. Labrador, C. Buquicchio, S. El-Ashwah, V. Petzer, Praet J. Van, M. Schonlein, M. Dargenio, Mendez G. -A., S. Meers, F. Itri, A. GiordanoL. I. Pinczes, I. Espigado, Z. Stojanoski, A. Lopez-Garcia, L. Prezioso, O. Jaksic, A. Vena, N. S. Fracchiolla, T. J. Gonzalez-Lopez, N. Colovic, M. Delia, B. Weinbergerova, M. Marchetti, de Almeida J. Marques, O. Finizio, C. Besson, M. M. Biernat, T. Valkovic, T. Lahmer, A. Cuccaro, I. Ormazabal-Velez, J. Batinic, N. Fernandez, Jonge N. De, C. Tascini, A. N. Anastasopoulou, R. Dulery, Principe M. I. Del, G. Plantefeve, M. V. Papa, M. Nucci, M. Jimenez, A. Aujayeb, Hernandez-Rivas J. -A., M. Merelli, C. Cattaneo, O. Blennow, A. Nordlander, A. Cabirta, G. Varricchio, M. V. Sacchi, R. Cordoba, E. Arellano, S. K. Grafe, D. Wolf, Z. Emarah, E. Ammatuna, D. S. Hersby, S. Martin-Perez, Rodrigues R. Nunes, L. Rahimli, Livio Pagano, O. A. Cornely^*, K. Piukovics, Ramon C. De, F. Danion, A. Yahya, A. Guidetti, C. Garcia-Vidal, U. Sili, J. Meletiadis, Kort E. De, L. Verga, L. Serrano, N. Erben, Blasi R. Di, A. Tragiannidis, Ribera-Santa Susana J. -M., Ommen H. -B., A. Busca, N. Coppola, R. Bergantim, G. Dragonetti, M. Criscuolo, Luana Fianchi, M. Bonanni, A. Soto-Silva, M. Mikulska, M. Machado, Kho C. Shan, N. Hassan, E. Gavriilaki, G. Cordini, L. Y. A. Chi, M. Eggerer, M. Hoenigl, J. Prattes, Jimenez-Lorenzo M. -J., S. Zompi, G. P. M. Zambrotta, G. M. Colak, N. Garcia-Pouton, T. F. Aiello, R. Prin, M. Stamouli, M. Samarkos

^*Autore corrispondente per questo lavoro

Risultato della ricerca: Contributo in rivista › Articolo

Abstract

Background: Nirmatrelvir/ritonavir treatment decreases the hospitalisation rate in immunocompetent patients with COVID-19, but data on efficacy in patients with haematological malignancy are scarce. Here, we describe the outcome of nirmatrelvir/ritonavir treatment in a large cohort of the latter patients. Methods: This is a retrospective cohort study from the multicentre EPICOVIDEHA registry (NCT04733729) on patients with haematological malignancy, who were diagnosed with COVID-19 between January and September 2022. Patients receiving nirmatrelvir/ritonavir were compared to those who did not. A logistic regression was run to determine factors associated with nirmatrelvir/ritonavir administration in our sample. Mortality between treatment groups was assessed with Kaplan–Meier survival plots after matching all the patients with a propensity score. Additionally, a Cox regression was modelled to detect factors associated with mortality in patients receiving nirmatrelvir/ritonavir. Findings: A total of 1859 patients were analysed, 117 (6%) were treated with nirmatrelvir/ritonavir, 1742 (94%) were treated otherwise. Of 117 patients receiving nirmatrelvir/ritonavir, 80% had received ≥1 anti-SARS-CoV-2 vaccine dose before COVID-19 onset, 13% of which received a 2nd vaccine booster. 5% were admitted to ICU. Nirmatrelvir/ritonavir treatment was associated with the presence of extrapulmonary symptoms at COVID-19 onset, for example anosmia, fever, rhinitis, or sinusitis (aOR 2.509, 95%CI 1.448–4.347) and 2nd vaccine booster (aOR 3.624, 95%CI 1.619–8.109). Chronic pulmonary disease (aOR 0.261, 95%CI 0.093–0.732) and obesity (aOR 0.105, 95%CI 0.014–0.776) were not associated with nirmatrelvir/ritonavir use. After propensity score matching, day-30 mortality rate in patients treated with nirmatrelvir/ritonavir was 2%, significantly lower than in patients with SARS-CoV-2 directed treatment other than nirmatrelvir/ritonavir (11%, p = 0.036). No factor was observed explaining the mortality difference in patients after nirmatrelvir/ritonavir administration. Interpretation: Haematological malignancy patients were more likely to receive nirmatrelvir/ritonavir when reporting extrapulmonary symptoms or 2nd vaccine booster at COVID-19 onset, as opposed to chronic pulmonary disease and obesity. The mortality rate in patients treated with nirmatrelvir/ritonavir was lower than in patients with targeted drugs other than nirmatrelvir/ritonavir. Funding: EPICOVIDEHA has received funds from Optics COMMIT (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223).

Lingua originale	Inglese
pagine (da-a)	101939-101947
Numero di pagine	9
Rivista	EClinicalMedicine
Volume	58
Numero di pubblicazione	58
DOI	https://doi.org/10.1016/j.eclinm.2023.101939
Stato di pubblicazione	Pubblicato - 2023

All Science Journal Classification (ASJC) codes

Medicina Generale

Keywords

COVID-19
Haematology
Malignancy
Nirmatrelvir
SARS-CoV-2

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10.1016/j.eclinm.2023.101939

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Salmanton-Garcia, J., Marchesi, F., Gomes, D. S. M., Farina, F., Davila-Valls, J., Bilgin, Y. M., Glenthoj, A., Falces-Romero, I., Van, D. J., Labrador, J., Buquicchio, C., El-Ashwah, S., Petzer, V., Van, P. J., Schonlein, M., Dargenio, M., -A., M. G., Meers, S., Itri, F., ... Samarkos, M. (2023). Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies: a report from the EPICOVIDEHA registry. EClinicalMedicine, 58(58), 101939-101947. https://doi.org/10.1016/j.eclinm.2023.101939

@article{fc1bc650ff4048da9790628f66e883ef,

title = "Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies: a report from the EPICOVIDEHA registry",

abstract = "Background: Nirmatrelvir/ritonavir treatment decreases the hospitalisation rate in immunocompetent patients with COVID-19, but data on efficacy in patients with haematological malignancy are scarce. Here, we describe the outcome of nirmatrelvir/ritonavir treatment in a large cohort of the latter patients. Methods: This is a retrospective cohort study from the multicentre EPICOVIDEHA registry (NCT04733729) on patients with haematological malignancy, who were diagnosed with COVID-19 between January and September 2022. Patients receiving nirmatrelvir/ritonavir were compared to those who did not. A logistic regression was run to determine factors associated with nirmatrelvir/ritonavir administration in our sample. Mortality between treatment groups was assessed with Kaplan–Meier survival plots after matching all the patients with a propensity score. Additionally, a Cox regression was modelled to detect factors associated with mortality in patients receiving nirmatrelvir/ritonavir. Findings: A total of 1859 patients were analysed, 117 (6\%) were treated with nirmatrelvir/ritonavir, 1742 (94\%) were treated otherwise. Of 117 patients receiving nirmatrelvir/ritonavir, 80\% had received ≥1 anti-SARS-CoV-2 vaccine dose before COVID-19 onset, 13\% of which received a 2nd vaccine booster. 5\% were admitted to ICU. Nirmatrelvir/ritonavir treatment was associated with the presence of extrapulmonary symptoms at COVID-19 onset, for example anosmia, fever, rhinitis, or sinusitis (aOR 2.509, 95\%CI 1.448–4.347) and 2nd vaccine booster (aOR 3.624, 95\%CI 1.619–8.109). Chronic pulmonary disease (aOR 0.261, 95\%CI 0.093–0.732) and obesity (aOR 0.105, 95\%CI 0.014–0.776) were not associated with nirmatrelvir/ritonavir use. After propensity score matching, day-30 mortality rate in patients treated with nirmatrelvir/ritonavir was 2\%, significantly lower than in patients with SARS-CoV-2 directed treatment other than nirmatrelvir/ritonavir (11\%, p = 0.036). No factor was observed explaining the mortality difference in patients after nirmatrelvir/ritonavir administration. Interpretation: Haematological malignancy patients were more likely to receive nirmatrelvir/ritonavir when reporting extrapulmonary symptoms or 2nd vaccine booster at COVID-19 onset, as opposed to chronic pulmonary disease and obesity. The mortality rate in patients treated with nirmatrelvir/ritonavir was lower than in patients with targeted drugs other than nirmatrelvir/ritonavir. Funding: EPICOVIDEHA has received funds from Optics COMMIT (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223).",

keywords = "COVID-19, Haematology, Malignancy, Nirmatrelvir, SARS-CoV-2, COVID-19, Haematology, Malignancy, Nirmatrelvir, SARS-CoV-2",

author = "J. Salmanton-Garcia and F. Marchesi and Gomes, \{da Silva M.\} and F. Farina and J. Davila-Valls and Bilgin, \{Y. M.\} and A. Glenthoj and I. Falces-Romero and Van, \{Doesum J.\} and J. Labrador and C. Buquicchio and S. El-Ashwah and V. Petzer and Van, \{Praet J.\} and M. Schonlein and M. Dargenio and -A., \{Mendez G.\} and S. Meers and F. Itri and A. Giordano and Pinczes, \{L. I.\} and I. Espigado and Z. Stojanoski and A. Lopez-Garcia and L. Prezioso and O. Jaksic and A. Vena and Fracchiolla, \{N. S.\} and Gonzalez-Lopez, \{T. J.\} and N. Colovic and M. Delia and B. Weinbergerova and M. Marchetti and Marques, \{de Almeida J.\} and O. Finizio and C. Besson and Biernat, \{M. M.\} and T. Valkovic and T. Lahmer and A. Cuccaro and I. Ormazabal-Velez and J. Batinic and N. Fernandez and De, \{Jonge N.\} and C. Tascini and Anastasopoulou, \{A. N.\} and R. Dulery and Del, \{Principe M. I.\} and G. Plantefeve and Papa, \{M. V.\} and M. Nucci and M. Jimenez and A. Aujayeb and -A., \{Hernandez-Rivas J.\} and M. Merelli and C. Cattaneo and O. Blennow and A. Nordlander and A. Cabirta and G. Varricchio and Sacchi, \{M. V.\} and R. Cordoba and E. Arellano and Grafe, \{S. K.\} and D. Wolf and Z. Emarah and E. Ammatuna and Hersby, \{D. S.\} and S. Martin-Perez and Nunes, \{Rodrigues R.\} and L. Rahimli and Livio Pagano and Cornely, \{O. A.\} and K. Piukovics and De, \{Ramon C.\} and F. Danion and A. Yahya and A. Guidetti and C. Garcia-Vidal and U. Sili and J. Meletiadis and De, \{Kort E.\} and L. Verga and L. Serrano and N. Erben and Di, \{Blasi R.\} and A. Tragiannidis and -M., \{Ribera-Santa Susana J.\} and -B., \{Ommen H.\} and A. Busca and N. Coppola and R. Bergantim and G. Dragonetti and M. Criscuolo and Luana Fianchi and M. Bonanni and A. Soto-Silva and M. Mikulska and M. Machado and Shan, \{Kho C.\} and N. Hassan and E. Gavriilaki and G. Cordini and Chi, \{L. Y. A.\} and M. Eggerer and M. Hoenigl and J. Prattes and -J., \{Jimenez-Lorenzo M.\} and S. Zompi and Zambrotta, \{G. P. M.\} and Colak, \{G. M.\} and N. Garcia-Pouton and Aiello, \{T. F.\} and R. Prin and M. Stamouli and M. Samarkos",

year = "2023",

doi = "10.1016/j.eclinm.2023.101939",

language = "English",

volume = "58",

pages = "101939--101947",

journal = "EClinicalMedicine",

issn = "2589-5370",

publisher = "Elsevier Ltd",

number = "58",

}

Salmanton-Garcia, J, Marchesi, F, Gomes, DSM, Farina, F, Davila-Valls, J, Bilgin, YM, Glenthoj, A, Falces-Romero, I, Van, DJ, Labrador, J, Buquicchio, C, El-Ashwah, S, Petzer, V, Van, PJ, Schonlein, M, Dargenio, M, -A., MG, Meers, S, Itri, F, Giordano, A, Pinczes, LI, Espigado, I, Stojanoski, Z, Lopez-Garcia, A, Prezioso, L, Jaksic, O, Vena, A, Fracchiolla, NS, Gonzalez-Lopez, TJ, Colovic, N, Delia, M, Weinbergerova, B, Marchetti, M, Marques, DAJ, Finizio, O, Besson, C, Biernat, MM, Valkovic, T, Lahmer, T, Cuccaro, A, Ormazabal-Velez, I, Batinic, J, Fernandez, N, De, JN, Tascini, C, Anastasopoulou, AN, Dulery, R, Del, PMI, Plantefeve, G, Papa, MV, Nucci, M, Jimenez, M, Aujayeb, A, -A., H-RJ, Merelli, M, Cattaneo, C, Blennow, O, Nordlander, A, Cabirta, A, Varricchio, G, Sacchi, MV, Cordoba, R, Arellano, E, Grafe, SK, Wolf, D, Emarah, Z, Ammatuna, E, Hersby, DS, Martin-Perez, S, Nunes, RR, Rahimli, L, Pagano, L, Cornely, OA, Piukovics, K, De, RC, Danion, F, Yahya, A, Guidetti, A, Garcia-Vidal, C, Sili, U, Meletiadis, J, De, KE, Verga, L, Serrano, L, Erben, N, Di, BR, Tragiannidis, A, -M., R-SSJ, -B., OH, Busca, A, Coppola, N, Bergantim, R, Dragonetti, G, Criscuolo, M, Fianchi, L, Bonanni, M, Soto-Silva, A, Mikulska, M, Machado, M, Shan, KC, Hassan, N, Gavriilaki, E, Cordini, G, Chi, LYA, Eggerer, M, Hoenigl, M, Prattes, J, -J., J-LM, Zompi, S, Zambrotta, GPM, Colak, GM, Garcia-Pouton, N, Aiello, TF, Prin, R, Stamouli, M & Samarkos, M 2023, 'Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies: a report from the EPICOVIDEHA registry', EClinicalMedicine, vol. 58, n. 58, pagg. 101939-101947. https://doi.org/10.1016/j.eclinm.2023.101939

TY - JOUR

T1 - Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies: a report from the EPICOVIDEHA registry

AU - Salmanton-Garcia, J.

AU - Marchesi, F.

AU - Gomes, da Silva M.

AU - Farina, F.

AU - Davila-Valls, J.

AU - Bilgin, Y. M.

AU - Glenthoj, A.

AU - Falces-Romero, I.

AU - Van, Doesum J.

AU - Labrador, J.

AU - Buquicchio, C.

AU - El-Ashwah, S.

AU - Petzer, V.

AU - Van, Praet J.

AU - Schonlein, M.

AU - Dargenio, M.

AU - -A., Mendez G.

AU - Meers, S.

AU - Itri, F.

AU - Giordano, A.

AU - Pinczes, L. I.

AU - Espigado, I.

AU - Stojanoski, Z.

AU - Lopez-Garcia, A.

AU - Prezioso, L.

AU - Jaksic, O.

AU - Vena, A.

AU - Fracchiolla, N. S.

AU - Gonzalez-Lopez, T. J.

AU - Colovic, N.

AU - Delia, M.

AU - Weinbergerova, B.

AU - Marchetti, M.

AU - Marques, de Almeida J.

AU - Finizio, O.

AU - Besson, C.

AU - Biernat, M. M.

AU - Valkovic, T.

AU - Lahmer, T.

AU - Cuccaro, A.

AU - Ormazabal-Velez, I.

AU - Batinic, J.

AU - Fernandez, N.

AU - De, Jonge N.

AU - Tascini, C.

AU - Anastasopoulou, A. N.

AU - Dulery, R.

AU - Del, Principe M. I.

AU - Plantefeve, G.

AU - Papa, M. V.

AU - Nucci, M.

AU - Jimenez, M.

AU - Aujayeb, A.

AU - -A., Hernandez-Rivas J.

AU - Merelli, M.

AU - Cattaneo, C.

AU - Blennow, O.

AU - Nordlander, A.

AU - Cabirta, A.

AU - Varricchio, G.

AU - Sacchi, M. V.

AU - Cordoba, R.

AU - Arellano, E.

AU - Grafe, S. K.

AU - Wolf, D.

AU - Emarah, Z.

AU - Ammatuna, E.

AU - Hersby, D. S.

AU - Martin-Perez, S.

AU - Nunes, Rodrigues R.

AU - Rahimli, L.

AU - Pagano, Livio

AU - Cornely, O. A.

AU - Piukovics, K.

AU - De, Ramon C.

AU - Danion, F.

AU - Yahya, A.

AU - Guidetti, A.

AU - Garcia-Vidal, C.

AU - Sili, U.

AU - Meletiadis, J.

AU - De, Kort E.

AU - Verga, L.

AU - Serrano, L.

AU - Erben, N.

AU - Di, Blasi R.

AU - Tragiannidis, A.

AU - -M., Ribera-Santa Susana J.

AU - -B., Ommen H.

AU - Busca, A.

AU - Coppola, N.

AU - Bergantim, R.

AU - Dragonetti, G.

AU - Criscuolo, M.

AU - Fianchi, Luana

AU - Bonanni, M.

AU - Soto-Silva, A.

AU - Mikulska, M.

AU - Machado, M.

AU - Shan, Kho C.

AU - Hassan, N.

AU - Gavriilaki, E.

AU - Cordini, G.

AU - Chi, L. Y. A.

AU - Eggerer, M.

AU - Hoenigl, M.

AU - Prattes, J.

AU - -J., Jimenez-Lorenzo M.

AU - Zompi, S.

AU - Zambrotta, G. P. M.

AU - Colak, G. M.

AU - Garcia-Pouton, N.

AU - Aiello, T. F.

AU - Prin, R.

AU - Stamouli, M.

AU - Samarkos, M.

PY - 2023

Y1 - 2023

N2 - Background: Nirmatrelvir/ritonavir treatment decreases the hospitalisation rate in immunocompetent patients with COVID-19, but data on efficacy in patients with haematological malignancy are scarce. Here, we describe the outcome of nirmatrelvir/ritonavir treatment in a large cohort of the latter patients. Methods: This is a retrospective cohort study from the multicentre EPICOVIDEHA registry (NCT04733729) on patients with haematological malignancy, who were diagnosed with COVID-19 between January and September 2022. Patients receiving nirmatrelvir/ritonavir were compared to those who did not. A logistic regression was run to determine factors associated with nirmatrelvir/ritonavir administration in our sample. Mortality between treatment groups was assessed with Kaplan–Meier survival plots after matching all the patients with a propensity score. Additionally, a Cox regression was modelled to detect factors associated with mortality in patients receiving nirmatrelvir/ritonavir. Findings: A total of 1859 patients were analysed, 117 (6%) were treated with nirmatrelvir/ritonavir, 1742 (94%) were treated otherwise. Of 117 patients receiving nirmatrelvir/ritonavir, 80% had received ≥1 anti-SARS-CoV-2 vaccine dose before COVID-19 onset, 13% of which received a 2nd vaccine booster. 5% were admitted to ICU. Nirmatrelvir/ritonavir treatment was associated with the presence of extrapulmonary symptoms at COVID-19 onset, for example anosmia, fever, rhinitis, or sinusitis (aOR 2.509, 95%CI 1.448–4.347) and 2nd vaccine booster (aOR 3.624, 95%CI 1.619–8.109). Chronic pulmonary disease (aOR 0.261, 95%CI 0.093–0.732) and obesity (aOR 0.105, 95%CI 0.014–0.776) were not associated with nirmatrelvir/ritonavir use. After propensity score matching, day-30 mortality rate in patients treated with nirmatrelvir/ritonavir was 2%, significantly lower than in patients with SARS-CoV-2 directed treatment other than nirmatrelvir/ritonavir (11%, p = 0.036). No factor was observed explaining the mortality difference in patients after nirmatrelvir/ritonavir administration. Interpretation: Haematological malignancy patients were more likely to receive nirmatrelvir/ritonavir when reporting extrapulmonary symptoms or 2nd vaccine booster at COVID-19 onset, as opposed to chronic pulmonary disease and obesity. The mortality rate in patients treated with nirmatrelvir/ritonavir was lower than in patients with targeted drugs other than nirmatrelvir/ritonavir. Funding: EPICOVIDEHA has received funds from Optics COMMIT (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223).

AB - Background: Nirmatrelvir/ritonavir treatment decreases the hospitalisation rate in immunocompetent patients with COVID-19, but data on efficacy in patients with haematological malignancy are scarce. Here, we describe the outcome of nirmatrelvir/ritonavir treatment in a large cohort of the latter patients. Methods: This is a retrospective cohort study from the multicentre EPICOVIDEHA registry (NCT04733729) on patients with haematological malignancy, who were diagnosed with COVID-19 between January and September 2022. Patients receiving nirmatrelvir/ritonavir were compared to those who did not. A logistic regression was run to determine factors associated with nirmatrelvir/ritonavir administration in our sample. Mortality between treatment groups was assessed with Kaplan–Meier survival plots after matching all the patients with a propensity score. Additionally, a Cox regression was modelled to detect factors associated with mortality in patients receiving nirmatrelvir/ritonavir. Findings: A total of 1859 patients were analysed, 117 (6%) were treated with nirmatrelvir/ritonavir, 1742 (94%) were treated otherwise. Of 117 patients receiving nirmatrelvir/ritonavir, 80% had received ≥1 anti-SARS-CoV-2 vaccine dose before COVID-19 onset, 13% of which received a 2nd vaccine booster. 5% were admitted to ICU. Nirmatrelvir/ritonavir treatment was associated with the presence of extrapulmonary symptoms at COVID-19 onset, for example anosmia, fever, rhinitis, or sinusitis (aOR 2.509, 95%CI 1.448–4.347) and 2nd vaccine booster (aOR 3.624, 95%CI 1.619–8.109). Chronic pulmonary disease (aOR 0.261, 95%CI 0.093–0.732) and obesity (aOR 0.105, 95%CI 0.014–0.776) were not associated with nirmatrelvir/ritonavir use. After propensity score matching, day-30 mortality rate in patients treated with nirmatrelvir/ritonavir was 2%, significantly lower than in patients with SARS-CoV-2 directed treatment other than nirmatrelvir/ritonavir (11%, p = 0.036). No factor was observed explaining the mortality difference in patients after nirmatrelvir/ritonavir administration. Interpretation: Haematological malignancy patients were more likely to receive nirmatrelvir/ritonavir when reporting extrapulmonary symptoms or 2nd vaccine booster at COVID-19 onset, as opposed to chronic pulmonary disease and obesity. The mortality rate in patients treated with nirmatrelvir/ritonavir was lower than in patients with targeted drugs other than nirmatrelvir/ritonavir. Funding: EPICOVIDEHA has received funds from Optics COMMIT (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223).

KW - COVID-19

KW - Haematology

KW - Malignancy

KW - Nirmatrelvir

KW - SARS-CoV-2

KW - COVID-19

KW - Haematology

KW - Malignancy

KW - Nirmatrelvir

KW - SARS-CoV-2

UR - https://publicatt.unicatt.it/handle/10807/235315

UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85151507775&origin=inward

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85151507775&origin=inward

U2 - 10.1016/j.eclinm.2023.101939

DO - 10.1016/j.eclinm.2023.101939

M3 - Article

SN - 2589-5370

VL - 58

SP - 101939

EP - 101947

JO - EClinicalMedicine

JF - EClinicalMedicine

IS - 58

ER -

Nirmatrelvir/ritonavir in COVID-19 patients with haematological malignancies: a report from the EPICOVIDEHA registry

Abstract

All Science Journal Classification (ASJC) codes

Keywords

OSS delle Nazioni Unite

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