Treatment with obinutuzumab leads to worse outcomes in hematological patients diagnosed with Omicron variant COVID-19

Background: Hematological malignancies (HM) patients treated with anti-CD20s are at a higher risk for COVID-19 complications, however, little is known about the difference between these agents. Aim: To investigate the prognosis of HM COVID-19 pateints treated with obinutuzumab in comparison to rituximab. Methods: Single-center population-based cohort study including all HM patients treated with anti-CD20s from June 2021 to April 2022. Diagnosis of COVID-19 was based on positive SARS-CoV-2 PCR omicron variant. The Median follow-up was four months. Results: Among 143 HM patients, 47 were diagnosed with COVID- 19, 27 in the rituximab group and 20 in the obinutuzumab group. All obinutuzumab-treated patients had indolent HM, versus only 40.7% among the rituximab group (p <0.001). 13/20 of the obinutuzumab group (65.0%) received anti-CD20s as maintenance therapy, while most of the rituximab patients, 21/27 (77.8%) were on induction phase therapy (p = 0.003). COVID-19 prognosis was worse among obinutuzumab patients with higher admission rates (60.0% vs. 25.9%, p = 0.019), more patients with severe-critical disease (35.0% vs.7.4%, p = 0.017), and accounts for all mortality cases (3/20 vs. 0/27, p = 0.038). Conclusions: Omicron-variant COVID-19 disease outcome was worse among HM patients treated with obinutuzumab comparing to rituximab. As this treatment has not been shown to increase overall survival when given as maintenance, In our opinion, it may be prudent to delay treatment with obinutuzumab or replace it with a less potent anti-CD20 as long as the COVID-19 epidemic continues.

SARS-CoV-2 universal screening upon adult hospital admission in Southern Israel.

As the prevalence of coronavirus disease 2019 (COVID-19) increased in the local community, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) universal screening was initiated for all adult patients admitted through the emergency departments (EDs) at Soroka University Medical Centre. Of 8518 patients screened, 288 (3.38%) tested positive. One hundred and thirty-three (46%) positive cases were asymptomatic and would have been admitted without necessary precautions. Patients with symptoms that may be attributable to COVID-19 were significantly older and were admitted through the medical ED. Patients of Bedouin Arab ethnicity accounted for half of those who tested positive, which was double their prevalence in the general population. These findings indicate that universal SARS-CoV-2 screening on adult hospital admission is crucial in areas with a high prevalence of COVID-19.