造血干细胞移植后免疫功能低下患者的 COVID-19:一项试点研究。

IF 1.5 Q3 HEMATOLOGY
血液科学(英文) Pub Date : 2024-01-25 eCollection Date: 2024-04-01 DOI:10.1097/BS9.0000000000000183
Zilu Zhang, Jingtao Huang, Luxiang Wang, Zengkai Pan, Jiayu Huang, Chuanhe Jiang, Sujiang Zhang, Su Li, Xiaoxia Hu
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引用次数: 0

摘要

造血干细胞移植(HSCT)后处于免疫重建早期的患者感染严重急性呼吸系统综合征冠状病毒2(SARS-CoV-2)的数据十分有限。在本研究中,我们回顾性调查了2022年接受造血干细胞移植患者中SARS-CoV-2感染的发生率和临床特征。研究连续纳入了患者(allo-HSCT,n = 80;auto-HSCT,n = 37)。SARS-CoV-2感染率为59.8%,从造血干细胞移植到2019年冠状病毒疾病(COVID-19)的中位间隔为4.8个月(范围:0.5-12)。大多数患者被归类为轻度(41.4%)或中度(38.6%),20%为重度/危重。COVID-19 没有导致死亡。进一步的分析表明,较低的循环 CD8+ T 细胞计数和服用钙神经蛋白酶抑制剂会增加感染 SARS-CoV-2 的风险。与轻度/中度疾病相比,使用利妥昔单抗会显著增加重度或危重 COVID-19 的概率(P < .001)。在多变量分析中,利妥昔单抗的使用与重症 COVID-19 相关。此外,COVID-19 对免疫重建没有显著影响。此外,研究还发现 Epstein-Barr 病毒感染和利妥昔单抗的使用可能会增加罹患重症的风险。我们的研究初步揭示了 SARS-CoV-2 对异体造血干细胞移植受者免疫重建和预后的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
COVID-19 in immunocompromised patients after hematopoietic stem cell transplantation: a pilot study.

Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients at early stage of immune reconstitution after hematopoietic stem cell transplantation (HSCT) are limited. In the present study, we retrospectively investigated the incidence and clinical features of SARS-CoV-2 infection in patients who underwent HSCT in 2022. Patients (allo-HSCT, n = 80; auto-HSCT, n = 37) were consecutively included in the study. The SARS-CoV-2 infection rate was 59.8%, and the median interval of HSCT to coronavirus disease 2019 (COVID-19) was 4.8 (range: 0.5-12) months. Most patients were categorized as mild (41.4%) or moderate (38.6%), and 20% as severe/critical. No deaths were attributable to COVID-19. Further analysis showed that lower circulating CD8+ T-cell counts and calcineurin inhibitor administration increased the risk of SARS-CoV-2 infection. Exposure to rituximab significantly increased the probability of severe or critical COVID-19 compared with that of mild/moderate illness (P < .001). In the multivariate analysis, rituximab use was associated with severe COVID-19. Additionally, COVID-19 had no significant effect on immune reconstitution. Furthermore, it was found that Epstein-Barr virus infection and rituximab administration possibly increase the risk of developing severe illness. Our study provides preliminary insights into the effect of SARS-CoV-2 on immune reconstitution and the outcomes of allo-HSCT recipients.

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CiteScore
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