Hematology Unit, Bnai Zion Medical Center, The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Maccabi Institute for Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel.
Blood. 2023 May 4;141(18):2239-2244. doi: 10.1182/blood.2022019017.
Patients with chronic lymphoid leukemia (CLL), even in the Omicron era and after vaccination, suffer from persistent COVID-19 infection, higher complications, and mortality compared with the general population. In this study, we evaluated retrospectively the effectiveness of nirmatrelvir + ritonavir among 1080 patients with CLL who were infected with severe acute respiratory syndrome coronavirus 2. Nirmatrelvir administration was associated with a reduction in COVID-19-related hospitalization or death by day 35. Specifically, the rate of COVID-19-related hospitalization or death in the treated group compared with the untreated group was 4.8% (14 out of 292) vs 10.2% (75 out of 733), respectively. Moreover, we report a 69% relative risk reduction in COVID-19-related hospitalization or death in patients with CLL at the age of ≥65 years. Multivariate analysis indicates that patients aged >65 years, patients who received heavy treatment (>2 previous treatments), patients with recent hospitalizations, intravenous immunoglobulin (IVIG) treatment, and comorbidity had significant improvement outcomes after treatment with nirmatrelvir.
患有慢性淋巴细胞白血病（CLL）的患者，即使在奥密克戎时代且已接种疫苗，与普通人群相比，仍会持续感染 COVID-19，出现更高的并发症和死亡率。在这项研究中，我们回顾性评估了 1080 例 CLL 患者感染严重急性呼吸综合征冠状病毒 2 后使用奈玛特韦/利托那韦的效果。奈玛特韦治疗与 COVID-19 相关的住院或死亡减少有关，第 35 天即可观察到。具体而言，治疗组与未治疗组 COVID-19 相关住院或死亡的发生率分别为 4.8%（14/292）和 10.2%（75/733）。此外，我们报告称≥65 岁的 CLL 患者 COVID-19 相关住院或死亡的相对风险降低了 69%。多变量分析表明，奈玛特韦治疗后，年龄>65 岁、接受过大量治疗（>2 次治疗）、最近住院、静脉注射免疫球蛋白（IVIG）治疗和合并症的患者具有显著的改善结局。
