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. 2023 Mar 7:14:1125824.
doi: 10.3389/fimmu.2023.1125824. eCollection 2023.

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  1   2 , Gloria Tridello  3 , Jose Luis Piñana  4   5 , Fabio Ciceri  6 , Henrik Sengeloev  7 , Alexander Kulagin  8 , Stephan Mielke  1   9 , Zeynep Arzu Yegin  10 , Matthew Collin  11 , Sigrun Einardottir  12   13 , Sophie Ducastelle Lepretre  14 , Johan Maertens  15 , Antonio Campos  16 , Elisabetta Metafuni  17 , Herbert Pichler  18 , Frantisek Folber  19   20 , Carlos Solano  3 , Emma Nicholson  21 , Meltem Kurt Yüksel  22 , Kristina Carlson  23 , Beatriz Aguado  24 , Caroline Besley  25 , Jenny Byrne  26 , Immaculada Heras  27 , Fiona Dignan  28 , Nicolaus Kröger  29 , Christine Robin  30 , Anjum Khan  31 , Stig Lenhoff  32 , Anna Grassi  33 , Veronika Dobsinska  34 , Nuno Miranda  35 , Maria-Jose Jimenez  36 , Ipek Yonal-Hindilerden  37 , Keith Wilson  38 , Dina Averbuch  39 , Simone Cesaro  40 , Alienor Xhaard  41 , Nina Knelange  42 , Jan Styczynski  43 , Malgorzata Mikulska  44 , Rafael de la Camara  24
Affiliations

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 et al. Front Immunol. .

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.

Keywords: CMV; COVID-19; allogeneic; risk factors; stem cell transplantation.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Distribution of cases over time.
Figure 2
Figure 2
Survival after diagnosis of COVID-19 in adults and children.
Figure 3
Figure 3
Overall survival after diagnosis of COVID-19 infection in allogeneic HCT recipients; split by calendar year.
Figure 4
Figure 4
Overall survival after diagnosis of COVID-19 in allogeneic HCT recipients split by pandemic phase.
Figure 5
Figure 5
Survival based on recipient CMV serostatus.
See this image and copyright information in PMC

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