COVID-19 disease in children and adolescents following allogeneic hematopoietic stem cell transplantation: A report from the Turkish pediatric bone marrow transplantation study group.
C. Bozkurt, V. Hazar, B. Malbora, A. Küpesiz, Utku Aygüneş, T. Fışgın, M. Karakükçü, B. Kuşkonmaz, S. Kılıc, D. Bayirli, Özlem Arman Bilir, K. Yalçın, Salih Gözmen, V. Uygun, M. Elli, H. Sarbay, F. Küpesiz, H. I. Sasmaz, B. Aksoy, Ebru Yılmaz, F. Okur, F. Tekkesin, Fatma Demir Yenigürbüz, Gülcihan Özek, A. Atay, İ. Bozkaya, S. Çelen, Seda Öztürkmen, A. M. Güneş, O. Gürsel, Elif Güler, Alper Özcan, D. Çetinkaya, S. Aydoğdu, Namık Yaşar Özbek, G. Karasu, G. Sezgin, Ömer Doğru, Davut Albayrak, G. Öztürk, S. Aksoylar, Hayriye Daloğlu, Işık Odaman Al, M. Evim, S. Akbayram, Yurday Öncül, E. Zengin, C. Albayrak, Ç. Timur, Y. D. Kar, H. Çakmaklı, Ö. Tüfekçi, Ersin Töret, Bulent Antmen
{"title":"COVID-19 disease in children and adolescents following allogeneic hematopoietic stem cell transplantation: A report from the Turkish pediatric bone marrow transplantation study group.","authors":"C. Bozkurt, V. Hazar, B. Malbora, A. Küpesiz, Utku Aygüneş, T. Fışgın, M. Karakükçü, B. Kuşkonmaz, S. Kılıc, D. Bayirli, Özlem Arman Bilir, K. Yalçın, Salih Gözmen, V. Uygun, M. Elli, H. Sarbay, F. Küpesiz, H. I. Sasmaz, B. Aksoy, Ebru Yılmaz, F. Okur, F. Tekkesin, Fatma Demir Yenigürbüz, Gülcihan Özek, A. Atay, İ. Bozkaya, S. Çelen, Seda Öztürkmen, A. M. Güneş, O. Gürsel, Elif Güler, Alper Özcan, D. Çetinkaya, S. Aydoğdu, Namık Yaşar Özbek, G. Karasu, G. Sezgin, Ömer Doğru, Davut Albayrak, G. Öztürk, S. Aksoylar, Hayriye Daloğlu, Işık Odaman Al, M. Evim, S. Akbayram, Yurday Öncül, E. Zengin, C. Albayrak, Ç. Timur, Y. D. Kar, H. Çakmaklı, Ö. Tüfekçi, Ersin Töret, Bulent Antmen","doi":"10.1111/petr.14758","DOIUrl":null,"url":null,"abstract":"BACKGROUND\nData on the risk factors and outcomes for pediatric patients with SARS-CoV-2 infection (COVID-19) following hematopoietic stem cell transplantation (HSCT) are limited.\n\n\nOBJECTIVES\nThe study aimed to analyze the clinical signs, risk factors, and outcomes for ICU admission and mortality in a large pediatric cohort who underwent allogeneic HSCT prior to COVID-19 infection.\n\n\nMETHOD\nIn this nationwide study, we retrospectively reviewed the data of 184 pediatric HSCT recipients who had COVID-19 between March 2020 and August 2022.\n\n\nRESULTS\nThe median time from HSCT to COVID-19 infection was 209.0 days (IQR, 111.7-340.8; range, 0-3845 days). The most common clinical manifestation was fever (58.7%). While most patients (78.8%) had asymptomatic/mild disease, the disease severity was moderate in 9.2% and severe and critical in 4.4% and 7.6%, respectively. The overall mortality was 10.9% (n: 20). Deaths were attributable to COVID-19 in nine (4.9%) patients. Multivariate analysis revealed that lower respiratory tract disease (LRTD) (OR, 23.20, p: .001) and lymphopenia at diagnosis (OR, 5.21, p: .006) were risk factors for ICU admission and that HSCT from a mismatched donor (OR, 54.04, p: .028), multisystem inflammatory syndrome in children (MIS-C) (OR, 31.07, p: .003), and LRTD (OR, 10.11, p: .035) were associated with a higher risk for COVID-19-related mortality.\n\n\nCONCLUSION\nWhile COVID-19 is mostly asymptomatic or mild in pediatric transplant recipients, it can cause ICU admission in those with LRTD or lymphopenia at diagnosis and may be more fatal in those who are transplanted from a mismatched donor and those who develop MIS-C or LRTD.","PeriodicalId":20038,"journal":{"name":"Pediatric Transplantation","volume":null,"pages":null},"PeriodicalIF":1.2000,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Transplantation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/petr.14758","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
BACKGROUND
Data on the risk factors and outcomes for pediatric patients with SARS-CoV-2 infection (COVID-19) following hematopoietic stem cell transplantation (HSCT) are limited.
OBJECTIVES
The study aimed to analyze the clinical signs, risk factors, and outcomes for ICU admission and mortality in a large pediatric cohort who underwent allogeneic HSCT prior to COVID-19 infection.
METHOD
In this nationwide study, we retrospectively reviewed the data of 184 pediatric HSCT recipients who had COVID-19 between March 2020 and August 2022.
RESULTS
The median time from HSCT to COVID-19 infection was 209.0 days (IQR, 111.7-340.8; range, 0-3845 days). The most common clinical manifestation was fever (58.7%). While most patients (78.8%) had asymptomatic/mild disease, the disease severity was moderate in 9.2% and severe and critical in 4.4% and 7.6%, respectively. The overall mortality was 10.9% (n: 20). Deaths were attributable to COVID-19 in nine (4.9%) patients. Multivariate analysis revealed that lower respiratory tract disease (LRTD) (OR, 23.20, p: .001) and lymphopenia at diagnosis (OR, 5.21, p: .006) were risk factors for ICU admission and that HSCT from a mismatched donor (OR, 54.04, p: .028), multisystem inflammatory syndrome in children (MIS-C) (OR, 31.07, p: .003), and LRTD (OR, 10.11, p: .035) were associated with a higher risk for COVID-19-related mortality.
CONCLUSION
While COVID-19 is mostly asymptomatic or mild in pediatric transplant recipients, it can cause ICU admission in those with LRTD or lymphopenia at diagnosis and may be more fatal in those who are transplanted from a mismatched donor and those who develop MIS-C or LRTD.
期刊介绍:
The aim of Pediatric Transplantation is to publish original articles of the highest quality on clinical experience and basic research in transplantation of tissues and solid organs in infants, children and adolescents. The journal seeks to disseminate the latest information widely to all individuals involved in kidney, liver, heart, lung, intestine and stem cell (bone-marrow) transplantation. In addition, the journal publishes focused reviews on topics relevant to pediatric transplantation as well as timely editorial comment on controversial issues.