Stem Cell Transplant Center, AOU Citta' della Salute e della Scienza, Turin, Italy.
University of Cologne, Faculty of Medicine and University Hospital Cologne, Translational Research, Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Cologne, Germany.
Front Immunol. 2023 Feb 24;14:1125030. doi: 10.3389/fimmu.2023.1125030. eCollection 2023.
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.
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.
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).
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.
异体造血干细胞移植（HSCT）受者 COVID-19 的结局几乎一致较差。本研究旨在回顾性分析大量发生 COVID-19 感染的异体 HSCT 患者的结局和死亡风险因素。
这项由欧洲血液学协会-血液学感染研究工作组推动的多中心回顾性研究，纳入了 2020 年 1 月至 2022 年 3 月期间发生 COVID-19 的 326 例成人 HSCT 患者。
从 HSCT 到 COVID-19 诊断的中位时间为 268 天（IQR 86-713；范围 0-185 天）。COVID-19 严重程度为轻度的患者占 21%，重度占 39%，危重度占 16%。多变量分析显示，年龄>50 岁、合并 3 种或以上合并症、COVID-19 感染时存在活动性血液系统疾病、HSCT 后 12 个月内发生 COVID-19 以及严重/危重症感染与死亡风险增加相关。总体死亡率为 21%（n=68）：COVID-19 是 16%（n=53）患者的主要或次要死因。
发生 COVID-19 的 HSCT 受者死亡率较高，且在很大程度上取决于年龄、合并症、活动性血液系统疾病、移植时间和感染严重程度。
