Frontiers in Immunology (Feb 2023)

Outcome of COVID-19 in allogeneic stem cell transplant recipients: Results from the EPICOVIDEHA registry

  • Alessandro Busca,
  • Jon Salmanton-García,
  • Jon Salmanton-García,
  • Francesco Marchesi,
  • Francesca Farina,
  • Guldane Cengiz Seval,
  • Jaap Van Doesum,
  • Nick De Jonge,
  • Nathan C. Bahr,
  • Johan Maertens,
  • Johan Maertens,
  • Joseph Meletiadis,
  • Nicola S. Fracchiolla,
  • Barbora Weinbergerová,
  • Luisa Verga,
  • Luisa Verga,
  • Zdeněk Ráčil,
  • Moraima Jiménez,
  • Moraima Jiménez,
  • Andreas Glenthøj,
  • Ola Blennow,
  • Alina Daniela Tanase,
  • Martin Schönlein,
  • Lucia Prezioso,
  • Nina Khanna,
  • Rafael F. Duarte,
  • Pavel Žák,
  • Marcio Nucci,
  • Marina Machado,
  • Austin Kulasekararaj,
  • Austin Kulasekararaj,
  • Ildefonso Espigado,
  • Elizabeth De Kort,
  • José-María Ribera-Santa Susana,
  • Monia Marchetti,
  • Gabriele Magliano,
  • Iker Falces-Romero,
  • Osman Ilhan,
  • Emanuele Ammatuna,
  • Sofia Zompi,
  • Panagiotis Tsirigotis,
  • Anastasia Antoniadou,
  • Giovanni Paolo Maria Zambrotta,
  • Giovanni Paolo Maria Zambrotta,
  • Anna Nordlander,
  • Linda Katharina Karlsson,
  • Michaela Hanakova,
  • Giulia Dragonetti,
  • Alba Cabirta,
  • Caroline Berg Venemyr,
  • Stefanie Gräfe,
  • Stefanie Gräfe,
  • Jens Van Praet,
  • Athanasios Tragiannidis,
  • Verena Petzer,
  • Alberto López-García,
  • Federico Itri,
  • Ana Groh,
  • Eleni Gavriilaki,
  • Michelina Dargenio,
  • Laman Rahimli,
  • Laman Rahimli,
  • Oliver A. Cornely,
  • Oliver A. Cornely,
  • Oliver A. Cornely,
  • Oliver A. Cornely,
  • Oliver A. Cornely,
  • Livio Pagano,
  • EPICOVIDEHA Consortium,
  • Juergen Prattes,
  • Malgorzata Mikulska,
  • Gustavo-Adolfo Méndez,
  • Tobias Lahmer,
  • Pavel Jindra,
  • Anna Guidetti,
  • Rita Fazzi,
  • Maria Ilaria Del Principe,
  • Cristina De Ramón,
  • Maria Calbacho,
  • Zlate Stojanoski,
  • Andrés Soto,
  • Alexandra Serris,
  • Irati Ormazabal-Vélez,
  • Ali S. Omrani,
  • Milan Navrátil,
  • Sonia Martín-Pérez,
  • Joyce Marques De Almeida,
  • Sylvain Lamure,
  • Martin Kolditz,
  • Ozren Jaksic,
  • Martin Hoenigl,
  • Carolina Garcia-Vidal,
  • Noemí Fernández,
  • Shaimaa El-Ashwah,
  • Natasha Čolović,
  • Martin Čerňan,
  • Caterina Buquicchio,
  • Valentina Bonuomo,
  • Josip Batinić,
  • Murtadha Al-Khabori,
  • Tatjana Adžić-Vukičević,
  • Juan-Alberto Martín-González,
  • Maria Vittoria Sacchi,
  • María-Josefa Jiménez-Lorenzo,
  • Dominik Wolf,
  • Maria Vehreschild,
  • Raul Cordoba,
  • Ramón García-Sanz,
  • Toni Valković,
  • Miloš Mladenović,
  • Nicole García-Poutón,
  • Ziad Emarah,
  • Julio Dávila-Valls

DOI
https://doi.org/10.3389/fimmu.2023.1125030
Journal volume & issue
Vol. 14

Abstract

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BackgroundThe 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.MethodsThis 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.ResultsThe 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).ConclusionsMortality 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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