Characteristics and Outcomes of Stem Cell Transplant Patients during the COVID-19 Era: A Systematic Review and Meta-Analysis

Author:

Kamal Mona1ORCID,Baudo Massimo2ORCID,Joseph Jacinth3,Geng Yimin4ORCID,Mohamed Omnia5ORCID,Rahouma Mohamed67ORCID,Greenbaum Uri89ORCID

Affiliation:

1. Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

2. Department of Cardiac Surgery, Spedali Civili di Brescia, 25123 Brescia, Italy

3. Hematology and Medical Oncology, University of Pittsburg Medical Center-Hillman Cancer Center, Altoona, PA 16601, USA

4. Research Medical Library, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA

5. Department of Medical Oncology, NCI, Cairo 11796, Egypt

6. Surgical Oncology Department, National Cancer Institute, Cairo 12613, Egypt

7. Cardiothoracic Surgery Department, Weill Cornell Medicine, New York, NY 10065, USA

8. Department of Hematology, Soroka University Medical Center, Beer Sheva 8410501, Israel

9. Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 8410501, Israel

Abstract

This systematic review and meta-analysis aims to identify the outcomes of stem cell transplant (SCT) patients during the COVID-19 era. Pooled event rates (PER) were calculated, and meta-regression was performed. A random effects model was utilized. In total, 36 eligible studies were included out of 290. The PER of COVID-19-related deaths and COVID-19-related hospital admissions were 21.1% and 55.2%, respectively. The PER of the use of hydroxychloroquine was 53.27%, of the receipt of immunosuppression it was 39.4%, and of the use of antivirals, antibiotics, and steroids it was 71.61%, 37.94%, and 18.46%, respectively. The PER of the time elapsed until COVID-19 infection after SCT of more than 6 months was 85.3%. The PER of fever, respiratory symptoms, and gastrointestinal symptoms were 70.9, 76.1, and 19.3%, respectively. The PER of acute and chronic GvHD were 40.2% and 60.9%, respectively. SCT patients are at a higher risk of severe COVID-19 infection and mortality. The use of dexamethasone improves the survival of hospitalized SCT patients with moderate to severe COVID-19 requiring supplemental oxygen or ventilation. The SCT patient group is a heterogeneous group with varying characteristics. The quality of reporting on these patients when infected with COVID-19 is not uniform and further prospective or registry studies are needed to better guide clinical care in this unique setting.

Publisher

MDPI AG

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