COVID-19 in immunocompromised patients after hematopoietic stem cell transplantation: a pilot study

Author:

Zhang Zilu1,Huang Jingtao1,Wang Luxiang1,Pan Zengkai1,Huang Jiayu1,Jiang Chuanhe1,Zhang Sujiang1,Li Su2,Hu Xiaoxia13

Affiliation:

1. National Research Center for Translational Medicine, State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, Ruijin Hospital, Shanghai JiaoTong University School of Medicine, Shanghai 200025, China

2. GoBroad Medical Institute of Hematology (Shanghai Center), Shanghai 201418, China

3. Collaborative Innovation Center of Hematology, Shanghai JiaoTong University School of Medicine; Shanghai 200025, China

Abstract

Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients at early stage of immune reconstitution after hematopoietic stem cell transplantation (HSCT) are limited. In the present study, we retrospectively investigated the incidence and clinical features of SARS-CoV-2 infection in patients who underwent HSCT in 2022. Patients (allo-HSCT, n = 80; auto-HSCT, n = 37) were consecutively included in the study. The SARS-CoV-2 infection rate was 59.8%, and the median interval of HSCT to coronavirus disease 2019 (COVID-19) was 4.8 (range: 0.5–12) months. Most patients were categorized as mild (41.4%) or moderate (38.6%), and 20% as severe/critical. No deaths were attributable to COVID-19. Further analysis showed that lower circulating CD8+ T-cell counts and calcineurin inhibitor administration increased the risk of SARS-CoV-2 infection. Exposure to rituximab significantly increased the probability of severe or critical COVID-19 compared with that of mild/moderate illness (P < .001). In the multivariate analysis, rituximab use was associated with severe COVID-19. Additionally, COVID-19 had no significant effect on immune reconstitution. Furthermore, it was found that Epstein–Barr virus infection and rituximab administration possibly increase the risk of developing severe illness. Our study provides preliminary insights into the effect of SARS-CoV-2 on immune reconstitution and the outcomes of allo-HSCT recipients.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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