Natural immunity to SARS-CoV-2 and breakthrough infections in vaccinated and unvaccinated patients with cancer
Por:
Cortellini, A, Aguilar-Company, J, Salazar, R, Bower, M, Sita-Lumsden, A, Plaja, A, Lee, AJX, Bertuzzi, A, Tondini, C, Diamantis, N, Martinez-Vila, C, Prat, A, Apthorp, E, Gennari, A and Pinato, DJ
Publicada:
9 nov 2022
Ahead of Print:
1 ago 2022
Resumen:
Background Consolidated evidence suggests spontaneous immunity from SARS-CoV-2 is not durable, leading to the risk of reinfection, especially in the context of newly emerging viral strains. In patients with cancer who survive COVID-19 prevalence and severity of SARS-CoV-2 reinfections are unknown. Methods We aimed to document natural history and outcome from SARS-CoV-2 reinfection in patients recruited to OnCovid (NCT04393974), an active European registry enrolling consecutive patients with a history of solid or haematologic malignancy diagnosed with COVID-19. Results As of December 2021, out of 3108 eligible participants, 1806 COVID-19 survivors were subsequently followed at participating institutions. Among them, 34 reinfections (1.9%) were reported after a median time of 152 days (range: 40-620) from the first COVID-19 diagnosis, and with a median observation period from the second infection of 115 days (95% CI: 27-196). Most of the first infections were diagnosed in 2020 (27, 79.4%), while most of reinfections in 2021 (25, 73.5%). Haematological malignancies were the most frequent primary tumour (12, 35%). Compared to first infections, second infections had lower prevalence of COVID-19 symptoms (52.9% vs 91.2%, P = 0.0008) and required less COVID-19-specific therapy (11.8% vs 50%, P = 0.0013). Overall, 11 patients (32.4%) and 3 (8.8%) were fully and partially vaccinated against SARS-CoV-2 before the second infection, respectively. The 14-day case fatality rate was 11.8%, with four death events, none of which among fully vaccinated patients. Conclusion This study shows that reinfections in COVID-19 survivors with cancer are possible and more common in patients with haematological malignancies. Reinfections carry a 11% risk of mortality, which rises to 15% among unvaccinated patients, highlighting the importance of universal vaccination of patients with cancer.
Filiaciones:
Cortellini, A:
Imperial Coll London, Hammersmith Hosp, Dept Surg & Canc, London, England
Fdn Policlin Univ Campus Biomed, Med Oncol, Rome, Italy
Aguilar-Company, J:
Vall dHebron Univ Hosp, Med Oncol, Barcelona, Spain
Inst Oncol VHIO, Barcelona, Spain
Vall dHebron Univ Hosp, Infect Dis, Barcelona, Spain
Salazar, R:
CIBERONC, ICO LHospitalet, Dept Med Oncol, Oncobell Program IDIBELL, Lhospitalet De Llobregat, Spain
Bower, M:
Chelsea & Westminster Hosp, Dept Oncol, London, England
Chelsea & Westminster Hosp, Natl Ctr HIV Malignancy, London, England
Sita-Lumsden, A:
Guys & St Thomas NHS Fdn Trust GSTT, Med Oncol, London, England
:
Catalan Inst Oncol Badalona, Med Oncol Dept, IGTP, B ARGO Grp, Badalona, Spain
Lee, AJX:
Univ Coll London Hosp, Canc Div, London, England
Bertuzzi, A:
IRCCS Humanitas Res Hosp, Humanitas Canc Ctr, Med Oncol & Hematol Unit, Milan, Italy
Tondini, C:
ASST Papa Giovanni XXIII, Oncol Unit, Bergamo, Italy
Diamantis, N:
Barts Hlth NHS Trust, Med Oncol, London, England
Martinez-Vila, C:
Fundacio Althaia Manresa, Manresa, Spain
Prat, A:
IDIBAPS, Translat Genom & Targeted Therapies Solid Tumors, Barcelona, Spain
Apthorp, E:
Kings Coll London, Med Sch, London, England
Gennari, A:
Univ Piemonte Orientale, Dept Translat Med, Div Oncol, Novara, Italy
Pinato, DJ:
Imperial Coll London, Hammersmith Hosp, Dept Surg & Canc, London, England
Univ Piemonte Orientale, Dept Translat Med, Div Oncol, Novara, Italy
Green Published, hybrid
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