组粒时代b细胞恶性肿瘤患者持续感染SARS-CoV-2的危险因素：一项多中心队列研究

IF 4.3 2区医学 Q1 INFECTIOUS DISEASES

International Journal of Infectious Diseases Pub Date : 2025-09-08 DOI:10.1016/j.ijid.2025.108053

Zeno Pasquini , Alice Toschi , Dino Gibertoni , Armando Amicucci , Beatrice Casadei , Cinzia Pellegrini , Alessandra D’Abramo , Patrizia De Marco , Linda Bussini , Maria Ciccone , Alessandro Visentin , Paula Olivares-Navarro , Michele Bartoletti , Emanuele Nicastri , Mauro Krampera , Pier Luigi Zinzani , Francesca Bonifazi , Pierluigi Viale , Zaira R. Palacios-Baena , Evelina Tacconelli , Maddalena Giannella

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引用次数: 0

摘要

背景：b细胞恶性肿瘤患者持续感染SARS-CoV-2的风险很高，这可能会延迟肿瘤治疗并增加发病率。我们的目的是评估这一人群持续感染的危险因素。方法：我们在2022年1月1日至2023年1月1日期间对五家三级医院进行了多中心回顾性研究。纳入b细胞恶性肿瘤和SARS-CoV-2感染的成年患者。持续感染定义为病毒脱落≥21天，并有临床和/或放射学征象。通过多变量logistic回归评估危险因素。结果：307例患者中，26.1%发生持续性感染。该队列包括非霍奇金淋巴瘤（67.4%）、慢性淋巴细胞白血病（19.2%）和霍奇金淋巴瘤（9.1%）。独立危险因素包括抗cd20治疗（OR 3.22; 95% CI 2.37-4.39）。结论：我们的研究结果有助于确定持续SARS-CoV-2感染的危险因素，支持b细胞恶性肿瘤患者的早期治疗。

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Risk factors for persisting SARS-CoV-2 infection in patients with B-cell malignancies in the Omicron era: A multicenter cohort study

Objectives

Patients with B-cell malignancies are at high risk of persisting SARS-CoV-2 infection, which may delay oncologic treatments and increase morbidity. We aimed to assess risk factors for persisting infection in this population.

Methods

We conducted a multicenter retrospective study across five tertiary hospitals between January 1, 2022, and January 1, 2023. Adult patients with B-cell malignancies and SARS-CoV-2 infection were included. Persisting infection was defined as viral shedding ≥21 days with clinical and/or radiological signs. Risk factors were evaluated through multivariable logistic regression.

Results

Among 307 patients, 26.1% developed persisting infection. The cohort included non-Hodgkin lymphoma (67.4%), chronic lymphocytic leukemia (19.2%), and Hodgkin lymphoma (9.1%). Independent risk factors included anti-cluster of differentiation 20 therapy (odds ratio [OR], 3.22; 95% confidence interval [CI], 2.37-4.39; P <0.001), and hospital admission at diagnosis (OR, 5.16; 95% CI, 2.37-12.45; P <0.001). Early therapy with nirmatrelvir/ritonavir (OR, 0.32; 95% CI, 0.19-0.54; P <0.001), remdesivir (OR, 0.26; 95% CI, 0.18-0.37; P <0.001), and sotrovimab (OR, 0.32; 95% CI, 0.15-0.67; P = 0.003) were protective. Mortality at 120 days was higher in the persisting group, though not statistically significant (12.5% vs 8.4%; P = 0.277).

Conclusions

Our findings help define risk factors for persisting SARS-CoV-2 infection and support early treatment in patients with B-cell malignancies.

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来源期刊

International Journal of Infectious Diseases 医学-传染病学

CiteScore

18.90

自引率

2.40%

发文量

1020

审稿时长

30 days

期刊介绍： International Journal of Infectious Diseases (IJID) Publisher: International Society for Infectious Diseases Publication Frequency: Monthly Type: Peer-reviewed, Open Access Scope: Publishes original clinical and laboratory-based research. Reports clinical trials, reviews, and some case reports. Focuses on epidemiology, clinical diagnosis, treatment, and control of infectious diseases. Emphasizes diseases common in under-resourced countries.