COVID-19 disease in children and adolescents following hematopoietic stem cell transplantation: A report from the Turkish Pediatric Bone Marrow Transplantation Study Group

Autor: CEYHUN BOZKURT, Volkan Hazar, Baris Malbora, Alphan Küpesiz, Utku Aygüneş, Tunc Fısgın, Musa Karakükçü, Baris Kuskonmaz, Suar Çakı Kilic, Derya Bayırlı, Özlem Arman Bilir, Koray Yalcin, Salih Gözmen, Vedat Uygun, Murat Elli, Hakan Sarbay, Funda Küpesiz, Hatice İlgen Şaşmaz, Basak Aksoy, Ebru Yılmaz, Fatma Okur, Funda Tekkeşin, Fatma Demir Yenigürbüz, Gülcihan Ozek, Avni Atay, İkbal Ok Bozkaya, Suna Çelen, Seda Ozturkmen, Adalet Gunes, Orhan Gursel, Elif Guler, Alper Özcan, Duygu Uçkan, Selime Aydogdu, Namık Yaşar Özbek, Gulsun Karasu, Gulay Sezgin, Omer Dogru, Davut Albayrak, Gülyüz Öztürk, Serap Aksoylar, Hayriye Daloglu, Işık Odaman Al, Melike Sezgin Evim, Sinan Akbayram, Yurday Öncül, Emine Zengin, Canan Albayrak, Timur Cetin, Yeter Düzenli Kar, Hasan Fatih Çakmaklı, Özlem Tüfekçi, Ersin Toret, Bulent Antmen
Rok vydání: 2023
Popis: Background: Data on the outcome and risk factors of pediatric patients with SARS-CoV-2 infection (COVID-19) following hematopoietic stem cell transplantation (HSCT) are limited. Objectives: We aimed to describe risk factors for a severe course and mortality. Method: In this nationwide study, data were collected retrospectively from 28 transplant centers. Results: One hundred ninety-six children [(63.8% male; median age 8.75 (IQR, 4.86-14.30)] who received allogeneic (n: 184, 93.9%) or autologous (n: 12, 6.1%) HSCT were included. The median time from HSCT to SARS-CoV-2 infection was 207.5 days (IQR, 110.2-207.5). The most common clinical manifestation was fever (58.2%), followed by cough (33.7%); 43 cases (21.9%) were asymptomatic. Lower respiratory tract disease (LRTD) and multisystem inflammatory syndrome in children (MIS-C) developed in 58 (29.6%) and 8 (4.1%) patients, respectively. Twenty-six patients (13.3%) required ICU admission. Nine patients died at a median of 17 days (min-max 1-33) after COVID-19 diagnosis, 6 of whom died due to the disease, with a COVID-19 lethality rate of 3.1%. The 6-week overall survival was 95.4% (95% CI 92.5-98.3). Multivariate analysis found that HSCT with a mismatched donor (OR, 8.98, p: 0.039) and LRTD (OR, 61.55, p: 0.001) were independent risk factors for ICU admission; MIS-C (OR, 9.55, p: 0.044) and lymphopenia (OR, 4.01, p: 0.030) at diagnosis were risk factors for mortality. Conclusion: Overall mortality was lower in children than in adult counterparts, and HSCT with a mismatched donor, lymphopenia, LRTD, MIS-C and ICU admission were important risk factors for adverse outcomes.
Databáze: OpenAIRE