Publication details

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

Authors	LJUNGMAN Per TRIDELLO Gloria PINANA Jose Luis CICERI Fabio SENGELOEV Henrik KULAGIN Alexander MIELKE Stephan YEGIN Zeynep Arzu COLLIN Matthew EINARDOTTIR Sigrun LEPRETRE Sophie Ducastelle MAERTENS Johan CAMPOS Antonio METAFUNI Elisabetta PICHLER Herbert FOLBER František SOLANO Carlos NICHOLSON Emma YUEKSEL Meltem Kurt CARLSON Kristina AGUADO Beatriz BESLEY Caroline BYRNE Jenny HERAS Immaculada DIGNAN Fiona KROEGER Nicolaus ROBIN Christine KHAN Anjum LENHOFF Stig GRASSI Anna DOBSINSKA Veronika MIRANDA Nuno JIMENEZ Maria-Jose YONAL-HINDILERDEN Ipek WILSON Keith AVERBUCH Dina CESARO Simone XHAARD Alienor KNELANGE Nina STYCZYNSKI Jan MIKULSKA Malgorzata RAFAEL de la Camara
Year of publication	2023
Type	Article in Periodical
Magazine / Source	Frontiers in immunology
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://www.frontiersin.org/articles/10.3389/fimmu.2023.1125824/full
Doi	http://dx.doi.org/10.3389/fimmu.2023.1125824
Keywords	COVID-19; allogeneic; stem cell transplantation; CMV; risk factors
Description	IntroductionCOVID-19 has been associated with high morbidity and mortality in allogeneic hematopoietic stem cell transplant (allo-HCT) recipients. MethodsThis study reports on 986 patients reported to the EBMT registry during the first 29 months of the pandemic. ResultsThe 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. DiscussionAlthough the outcome of COVID-19 has improved, patients having risk factors were still at risk for severe COVID-19 including death.