Department of Microbiology and Molecular Medicine, University of Geneva, Geneva, Switzerland.
Division of Hematology, Department of Oncology, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland.
Am J Transplant. 2023 Jun;23(6):844-847. doi: 10.1016/j.ajt.2023.03.015. Epub 2023 Mar 25.
Peripheral allogeneic hematopoietic stem cell transplant recipients are the most vulnerable patients to community-acquired respiratory viruses such as respiratory syncytial virus, influenza virus, or others. These patients are likely to develop severe acute viral infections; community-acquired respiratory viruses have also been identified as triggers of bronchiolitis obliterans (BO). BO is a manifestation of pulmonary graft-versus-host disease, most often leading to irreversible ventilatory impairment. To date, there are no data on whether Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could be a trigger for BO. Here, we report the first report of a case of bronchiolitis obliterans syndrome following SARS-CoV-2 infection occurring 10 months after allogeneic hematopoietic stem cell transplant with a flare of underlying extra thoracic graft-versus-host disease. This observation provides a new perspective and should be of particular interest to clinicians, suggesting the need for close monitoring of pulmonary function test (PFTs) after SARS-CoV-2 infection. The mechanisms leading to bronchiolitis obliterans syndrome after SARS-CoV-2 infection require further investigation.
异基因造血干细胞移植受者是最易感染呼吸道病毒（如呼吸道合胞病毒、流感病毒或其他病毒）的社区获得性呼吸道病毒的患者。这些患者可能会发生严重的急性病毒感染；社区获得性呼吸道病毒也已被确定为闭塞性细支气管炎（BO）的触发因素。BO 是肺移植物抗宿主病的一种表现，最常导致不可逆转的通气功能障碍。迄今为止，尚无关于严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）是否可能引发 BO 的数据。在这里，我们报告首例 SARS-CoV-2 感染后发生 BO 综合征的病例，该病例发生在异基因造血干细胞移植后 10 个月，同时伴有胸外移植物抗宿主病的加重。这一观察结果提供了一个新的视角，应该特别引起临床医生的关注，表明 SARS-CoV-2 感染后需要密切监测肺功能测试（PFT）。SARS-CoV-2 感染后导致闭塞性细支气管炎综合征的机制需要进一步研究。
