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中东地区的一项区域报告:造血细胞移植患者中 COVID-19 的临床病程和转归。

Clinical course and outcomes of COVID-19 in hematopoietic cell transplant patients, a regional report from the Middle East.

机构信息

King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Sultan Qaboos University, Muscat, Oman.

出版信息

Bone Marrow Transplant. 2021 Sep;56(9):2144-2151. doi: 10.1038/s41409-021-01312-y. Epub 2021 Apr 27.

Abstract

The coronavirus disease-2019 (COVID-19) caused by SARS Coronavirus 2 (SARS-CoV-2) is a potentially lethal infection. Cancer patients, and specifically hematopoietic cell transplant (HCT) recipients are severely immunocompromised and may be at a higher risk of a complicated course with this infection. We aimed to study the COVID-19 outcomes and severity in post HCT patients. We retrospectively reviewed post-HCT patients diagnosed with COVID-19 between March 15, 2020, and December 1, 2020 at 10 transplant centers across the Middle East. We identified 91 patients with confirmed SARS-CoV-2 infection across 10 transplant centers. The median age upon presentation with COVID-19 was 35. Fifty two patients were post allo-HCT while the remaining 39 patients were post auto-HCT. The median time from transplant was 14.9 months. Mortality rate was 4.4%. Hospital admission rate was 53%. ICU admission rate was 14%. Mechanical ventilation rate was 10%. Oxygen supplementation rate was 18%. Time from HCT to COVID-19 >6 months was associated with lower admission rates and lower rates of the "severity" composite endpoint. Antibody responses was seen 67% of evaluable patients. In this series of HCT recipients, we report overall favorable clinical outcomes for patients with COVID-19 and provide preliminary insights into the clinical course of this disease in this specific population.

摘要

由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的 2019 年冠状病毒病(COVID-19)是一种潜在致命的感染。癌症患者,特别是造血细胞移植(HCT)受者严重免疫功能低下,可能面临更严重的感染和更复杂的病程。我们旨在研究 HCT 后患者 COVID-19 的结局和严重程度。我们回顾性分析了 2020 年 3 月 15 日至 2020 年 12 月 1 日期间中东 10 个移植中心诊断为 COVID-19 的 HCT 后患者。我们在 10 个移植中心共发现 91 例确诊 SARS-CoV-2 感染的患者。COVID-19 就诊时的中位年龄为 35 岁。52 例患者为allo-HCT 后,其余 39 例为 auto-HCT 后。移植后中位时间为 14.9 个月。死亡率为 4.4%。住院率为 53%。入重症监护病房(ICU)率为 14%。机械通气率为 10%。吸氧率为 18%。HCT 后至 COVID-19 的时间>6 个月与较低的住院率和较低的“严重程度”综合终点发生率相关。在可评估的患者中,有 67%的患者出现抗体反应。在本系列 HCT 受者中,我们报告 COVID-19 患者总体临床结局良好,并为该疾病在该特定人群中的临床病程提供初步见解。

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