COVID-19 in hematopoietic stem cell transplant recipients during three years of the pandemic: a multicenter study in Brazil

Hematopoietic stem cell transplant (HSCT) recipients are at -increased risk for severe COVID-19. The aim of this study was to evaluate the burden of COVID-19 in a cohort of HSCT recipients. This retrospective study evaluated a cohort of adult hospitalized HSCT recipients diagnosed with COVID-19 in t...

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Veröffentlicht in:Revista do Instituto de Medicina Tropical de São Paulo 2024-01, Vol.66, p.e17-7
Hauptverfasser: Randi, Bruno Azevedo, Higashino, Hermes Ryoiti, Silva, Vinícius Ponzio da, Salomão, Matias Chiarastelli, Pignatari, Antonio Carlos Campos, Abdala, Edson, Vasques, Fabiana, Silva, Celso Arrais Rodrigues da, Silva, Roberto Luiz da, Lazari, Carolina Dos Santos, Levi, José Eduardo, Xavier, Erick Menezes, Côrtes, Marina Farrel, Luna-Muschi, Alessandra, Rocha, Vanderson, Costa, Silvia Figueiredo
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Sprache:eng
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Zusammenfassung:Hematopoietic stem cell transplant (HSCT) recipients are at -increased risk for severe COVID-19. The aim of this study was to evaluate the burden of COVID-19 in a cohort of HSCT recipients. This retrospective study evaluated a cohort of adult hospitalized HSCT recipients diagnosed with COVID-19 in two large hospitals in São Paulo, Brazil post-HSCT, from January 2020 to June 2022. The primary outcome was all-cause mortality. Of 49 cases, 63.2% were male with a median age of 47 years. Allogeneic-HSCT (51.2%) and autologous-HSCT (48.9%) patients were included. The median time from HSCT to COVID-19 diagnosis was 398 days (IQR: 1211-134), with 22 (44.8%) cases occurring within 12 months of transplantation. Most cases occurred during the first year of the pandemic, in non-vaccinated patients (n=35; 71.4%). Most patients developed severe (24.4%) or critical (40.8%) disease; 67.3% received some medication for COVID-19, primarily corticosteroids (53.0%). The probable invasive aspergillosis prevalence was 10.2%. All-cause mortality was 40.8%, 51.4% in non-vaccinated patients and 14.2% in patients who received at least one dose of the vaccine. In the multiple regression analyses, the variables mechanical ventilation (OR: 101.01; 95% CI: 8.205 - 1,242.93; p = 0.003) and chest CT involvement at diagnosis ≥50% (OR: 26.61; 95% CI: 1.06 - 664.26; p = 0.04) remained associated with all-cause mortality. Thus, HSCT recipients with COVID-19 experienced high mortality, highlighting the need for full vaccination and infection prevention measures.
ISSN:1678-9946
0036-4665
1678-9946
DOI:10.1590/S1678-9946202466017