Abstract
This study reports on 382 COVID-19 patients having undergone allogeneic (n = 236) or autologous (n = 146) hematopoietic cell transplantation (HCT) reported to the European Society for Blood and Marrow Transplantation (EBMT) or to the Spanish Group of Hematopoietic Stem Cell Transplantation (GETH). The median age was 54.1 years (1.0–80.3) for allogeneic, and 60.6 years (7.7–81.6) for autologous HCT patients. The median time from HCT to COVID-19 was 15.8 months (0.2–292.7) in allogeneic and 24.6 months (−0.9 to 350.3) in autologous recipients. 83.5% developed lower respiratory tract disease and 22.5% were admitted to an ICU. Overall survival at 6 weeks from diagnosis was 77.9% and 72.1% in allogeneic and autologous recipients, respectively. Children had a survival of 93.4%. In multivariate analysis, older age (p = 0.02), need for ICU (p < 0.0001) and moderate/high immunodeficiency index (p = 0.04) increased the risk while better performance status (p = 0.001) decreased the risk for mortality. Other factors such as underlying diagnosis, time from HCT, GVHD, or ongoing immunosuppression did not significantly impact overall survival. We conclude that HCT patients are at high risk of developing LRTD, require admission to ICU, and have increased mortality in COVID-19.
Highlights
A novel coronavirus named SARS-CoV-2 emerged at the end of 2019, and Coronavirus Disease 2019 (COVID-19) started spreading worldwide [1,2,3]
We present a series of 382 patients from 22 countries collected prospectively through the European Society for Blood and Marrow Transplantation (EBMT) registry and in close collaboration with the Spanish GETH, which is the largest patient cohort with COVID-19 after hematopoietic cell transplantation (HCT) presented to date
COVID-19 was a severe complication in HCT recipients with an attributable mortality of 25%
Summary
A novel coronavirus named SARS-CoV-2 emerged at the end of 2019, and Coronavirus Disease 2019 (COVID-19) started spreading worldwide [1,2,3]. The WHO classified COVID-19 a pandemic on March 11, 2020, and as of February 8, 2021, more than 106 million cases have been verified worldwide, and more than 2,300,000 have died. The EBMT has published recommendations regarding polices and patient management [4]. These authors contributed : Per Ljungman, Rafael de la Camara
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