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

Alessandro Busca, Jon Salmanton-García, Francesco Marchesi, Francesca Farina, Guldane Cengiz Seval, Jaap van Doesum, Nick de Jonge, Nathan C. Bahr, Johan Maertens, Joseph Meletiadis, Nicola S. Fracchiolla, Barbora Weinbergerová, Luisa Verga, Zdeněk Ráčil, Moraima Jiménez, Andreas Glenthøj, Ola Blennow, Alina Daniela Tanase, Martin Schönlein, Lucia PreziosoNina Khanna, Rafael F. Duarte, Pavel Žák, Marcio Nucci, Marina Machado, 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, Anna Nordlander, Linda Katharina Karlsson, Michaela Hanakova, Giulia Dragonetti, Alba Cabirta, Caroline Berg Venemyr, Stefanie Gräfe, Jens van Praet, Athanasios Tragiannidis, Verena Petzer, Alberto López-García, Federico Itri, Ana Groh, Eleni Gavriilaki, Michelina Dargenio, Laman Rahimli, Oliver A. Cornely, Livio Pagano

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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.
Original languageEnglish
Article number1125030
JournalFrontiers in immunology
Volume14
DOIs
Publication statusPublished - 2023

Keywords

  • COVID-19 infection
  • SARS-CoV-2
  • allogeneic HSCT
  • hematological malignances
  • immunocompromised patients

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