Background: The outcome of COVID-19 in allogeneic hematopoietic stem cell transplantation (HSCT) recipients is almost uniformely considered poor. The aim of present study was to retrospectively analyse the outcome and risk factors for mortality in a large series of patients who developed COVID-19 infection after an allogeneic HSCT. Methods: This multicenter retrospective study promoted by the European Hematology Association – Infections in Hematology Study Working Group, included 326 adult HSCT patients who had COVID-19 between January 2020 and March 2022. Results: The median time from HSCT to the diagnosis of COVID-19 was 268 days (IQR 86-713; range 0-185 days). COVID-19 severity was mild in 21% of the patients, severe in 39% and critical in 16% of the patients. In multivariable analysis factors associated with a higher risk of mortality were, age above 50 years, presence of 3 or more comorbidities, active hematologic disease at time of COVID-19 infection, development of COVID-19 within 12 months of HSCT, and severe/critical infections. Overall mortality rate was 21% (n=68): COVID-19 was the main or secondary cause of death in 16% of the patients (n=53). Conclusions: Mortality in HSCT recipients who develop COVID-19 is high and largely dependent on age, comorbidities, active hematologic disease, timing from transplant and severity of the infection.
Busca, A., Salmanton-Garcia, J., Marchesi, F., Farina, F., Seval, G. C., Van Doesum, J., De Jonge, N., Bahr, N. C., Maertens, J., Meletiadis, J., Fracchiolla, N. S., Weinbergerova, B., Verga, L., Racil, Z., Jimenez, M., Glenthoj, A., Blennow, O., Tanase, A. D., Schonlein, M., Prezioso, L., Khanna, N., Duarte, R. F., Zak, P., Nucci, M., Machado, M., Kulasekararaj, A., Espigado, I., De Kort, E., Ribera-Santa Susana, J. -., Marchetti, M., Magliano, G., Falces-Romero, I., Ilhan, O., Ammatuna, E., Zompi, S., Tsirigotis, P., Antoniadou, A., Zambrotta, G. P. M., Nordlander, A., Karlsson, L. K., Hanakova, M., Dragonetti, G., Cabirta, A., Berg Venemyr, C., Grafe, S., Van Praet, J., Tragiannidis, A., Petzer, V., Lopez-Garcia, A., Itri, F., Groh, A., Gavriilaki, E., Dargenio, M., Rahimli, L., Cornely, O. A., Pagano, L., Outcome of COVID-19 in allogeneic stem cell transplant recipients: Results from the EPICOVIDEHA registry, <<FRONTIERS IN IMMUNOLOGY>>, 2023; 14 (1125030): 1125030-1125037. [doi:10.3389/fimmu.2023.1125030] [https://hdl.handle.net/10807/235311]
Outcome of COVID-19 in allogeneic stem cell transplant recipients: Results from the EPICOVIDEHA registry
Dragonetti, GiuliaMembro del Collaboration Group
;Pagano, LivioConceptualization
2023
Abstract
Background: The outcome of COVID-19 in allogeneic hematopoietic stem cell transplantation (HSCT) recipients is almost uniformely considered poor. The aim of present study was to retrospectively analyse the outcome and risk factors for mortality in a large series of patients who developed COVID-19 infection after an allogeneic HSCT. Methods: This multicenter retrospective study promoted by the European Hematology Association – Infections in Hematology Study Working Group, included 326 adult HSCT patients who had COVID-19 between January 2020 and March 2022. Results: The median time from HSCT to the diagnosis of COVID-19 was 268 days (IQR 86-713; range 0-185 days). COVID-19 severity was mild in 21% of the patients, severe in 39% and critical in 16% of the patients. In multivariable analysis factors associated with a higher risk of mortality were, age above 50 years, presence of 3 or more comorbidities, active hematologic disease at time of COVID-19 infection, development of COVID-19 within 12 months of HSCT, and severe/critical infections. Overall mortality rate was 21% (n=68): COVID-19 was the main or secondary cause of death in 16% of the patients (n=53). Conclusions: Mortality in HSCT recipients who develop COVID-19 is high and largely dependent on age, comorbidities, active hematologic disease, timing from transplant and severity of the infection.
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