Improved outcomes over time and higher mortality in CMV seropositive allogeneic stem cell transplantation patients with COVID-19; An infectious disease working party study from the European Society for Blood and Marrow Transplantation registry

Per Ljungman*, Gloria Tridello, Jose Luis Piñana, Fabio Ciceri, Henrik Sengeloev, Alexander Kulagin, Stephan Mielke, Zeynep Arzu Yegin, Matthew Collin, Sigrun Einardottir, Sophie Ducastelle Lepretre, Johan Maertens, Antonio Campos, Elisabetta Metafuni, Herbert Pichler, Frantisek Folber, Carlos Solano, Emma Nicholson, Meltem Kurt Yüksel, Kristina CarlsonBeatriz Aguado, Caroline Besley, Jenny Byrne, Immaculada Heras, Fiona Dignan, Nicolaus Kröger, Christine Robin, Anjum Khan, Stig Lenhoff, Anna Grassi, Veronika Dobsinska, Nuno Miranda, Maria-Jose Jimenez, Ipek Yonal-Hindilerden, Keith Wilson, Dina Averbuch, Simone Cesaro, Alienor Xhaard, Nina Knelange, Jan Styczynski, Malgorzata Mikulska, Rafael de la Camara

*Corresponding author for this work
7 Citations (Scopus)

Abstract

INTRODUCTION: COVID-19 has been associated with high morbidity and mortality in allogeneic hematopoietic stem cell transplant (allo-HCT) recipients.

METHODS: This study reports on 986 patients reported to the EBMT registry during the first 29 months of the pandemic.

RESULTS: The median age was 50.3 years (min - max; 1.0 - 80.7). The median time from most recent HCT to diagnosis of COVID-19 was 20 months (min - max; 0.0 - 383.9). The median time was 19.3 (0.0 - 287.6) months during 2020, 21.2 (0.1 - 324.5) months during 2021, and 19.7 (0.1 - 383.9) months during 2022 (p = NS). 145/986 (14.7%) patients died; 124 (12.6%) due to COVID-19 and 21 of other causes. Only 2/204 (1%) fully vaccinated patients died from COVID-19. There was a successive improvement in overall survival over time. In multivariate analysis, increasing age (p<.0001), worse performance status (p<.0001), contracting COVID-19 within the first 30 days (p<.0001) or 30 - 100 days after HCT (p=.003), ongoing immunosuppression (p=.004), pre-existing lung disease (p=.003), and recipient CMV seropositivity (p=.004) had negative impact on overall survival while patients contracting COVID-19 in 2020 (p<.0001) or 2021 (p=.027) had worse overall survival than patients with COVID-19 diagnosed in 2022.

DISCUSSION: Although the outcome of COVID-19 has improved, patients having risk factors were still at risk for severe COVID-19 including death.

Original languageEnglish
Article number1125824
JournalFrontiers in Immunology
Volume14
ISSN1664-3224
DOIs
Publication statusPublished - 2023

Keywords

  • Humans
  • Middle Aged
  • Bone Marrow
  • Transplantation, Homologous
  • COVID-19/complications
  • Hematopoietic Stem Cell Transplantation/adverse effects
  • Communicable Diseases/complications
  • Cytomegalovirus Infections/complications
  • Registries
  • risk factors
  • stem cell transplantation
  • CMV
  • COVID-19
  • allogeneic

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