P1532: CLINICAL OUTCOMES OF COVID-19 IN MYCOSIS FUNGOIDES AND SEZARY SYNDROME (MF/SS)

Topic: 30. Infections in hematology (incl. supportive care/therapy) Background: Between 2020 and 2022, COVID-19 affected more than 70% of the Israeli population. It is now well known that haemato-oncologic patients are more susceptible to severe infections, including persistent COVID, and have a lower immune-response to COVID-19 vaccines than the general population. However, there is limited research on the outcomes of COVID-19 infection among patients with primary cutaneous lymphomas, such as Mycosis Fungoides and Sezary Syndrome (MF/SS). Aims: We aimed to assess the clinical outcomes of COVID-19 among patients with MF/SS during the period of 2020-2022. Methods: The data was retrieved from anonymized electronic medical records of Maccabi Healthcare Services, the second largest healthcare organization in Israel, after receiving approval from the institute’s ethical committee. Patients diagnosed with MF/SS by dermatologists, hematologists, or plastic surgeons and coded according to the ICD-9 system were included in the study. COVID-19 PCR test results, socio-demographic and clinical data were extracted and analyzed. Correlations tests and multivariate analyses were used to evaluate the association between COVID-19 infection, different COVID-19 variants, treatment, vaccination status, and clinical outcomes. Results: A total of 1472 patients diagnosed with MF/SS between 2020 and 2022 were included in the study. Among them, 768 (52%) had at least one confirmed SARS-CoV-2 infection by a PCR test, which was more prevalent among younger patients (p<0.001) and patients with comorbidities such as hypertension (p=0.009), overweight (p=0.001), kidney failure (p=0.046), osteoporosis (p=0.003) or dementia (p=0.046). The hospitalization rate was 2.9%, and the 30-day mortality rate from any cause after COVID-19 infection was 1.2% during the study period. Delta had the highest hospitalization rate (7.7%), among the three main COVID-19 variants, followed by Alpha (2.4%) and then Omicron (2.0%). During the Delta and Omicron surges, the hospitalization rate was lower among fully vaccinated patients, compared to non-vaccinated or non-fully vaccinated (p=0.032). However, it was higher among patients older than 65 (p<0.001) and patients with SS (vs. MF) (p<0.001) or COPD (p=0.024) diagnosis. Since January 2, 2022, the first day Nirmatrelvir was available for Maccabi patients, nirmatrelvir + ritonavir was administrated to 76 (11%) patients. There was a tendency for decreased hospitalization among patients treated within five days of infection, with a 79% risk reduction, although it was not statistically significant (p=0.164). Summary/Conclusion: It seems that patients with MF/SS do not necessarily have worse COVID-19 outcomes compared to the general population. However, further studies are needed to evaluate the effects of the different MF/SS treatments on COVID-19 severity and antibody formation to vaccination.Keywords: Mycosis fungoides, COVID-19