Characteristics of Coronavirus Disease in Allogeneic Hematopoietic Stem Cell Transplantation during the Omicron Wave: A Single-Center Study

Abstract

This study outlined the clinical characteristics, outcomes, and risk factors for coronavirus disease 2019 (COVID-19) of 492 patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT) during the Omicron wave. The median follow-up of the whole cohort was 62 days. The commonest underlying disease were myeloid malignancies (58.5%) and acute lymphocytic leukemia (30.5%). Of the 492 patients, 415, 67, and 10 had mild, moderate, and severe COVID-19, respectively. The incidence of moderate-to-severe COVID-19 was 15.7% (77/492). The 60-day overall survival and complete resolution rates were 98.1% and 80.6%, respectively. Risk factors for moderate-to-severe COVID-19 were corticosteroid use within 3 months before diagnosis (Odds ratio [OR], 2.115; 95% confidence interval [CI], 1.262-3.546; P=0.004), interval between allo-HSCT and coronavirus disease diagnosis <6 months (OR, 2.234; 95% CI, 1.259-3.969; P=0.006), and anti-thymocyte globulin use for graft-versus-host disease prophylaxis (OR, 3.450; 95% CI, 1.040-11.444; P=0.043). In conclusion, during the Omicron wave, patients with allo-HSCT had a low coronavirus disease-related mortality, and there was a high rate of moderate-to-severe disease and prolonged disease. Prevention in the early post-transplantation period is critical for allo-HSCT recipients receiving corticosteroids.