1. Clinical Characteristics and Outcomes of COVID-19 in Pediatric and Early Adolescent and Young Adult Hematopoietic Stem Cell Transplant Recipients: A Cohort Study
- Author
-
Neel S. Bhatt, Akshay Sharma, Andrew St. Martin, Muhammad Bilal Abid, Valerie I. Brown, Miguel Angel Diaz Perez, Haydar Frangoul, Shahinaz M. Gadalla, Megan M. Herr, Maxwell M. Krem, Hillard M. Lazarus, Michael J. Martens, Parinda A. Mehta, Taiga Nishihori, Tim Prestidge, Michael A. Pulsipher, Hemalatha G. Rangarajan, Kirsten M. Williams, Lena E. Winestone, Dwight E. Yin, Marcie L. Riches, Christopher E. Dandoy, and Jeffery J. Auletta
- Subjects
Pediatric ,Transplantation ,Pediatric Research Initiative ,Adolescent ,Early adolescent and young adult ,Prevention ,Hematopoietic Stem Cell Transplantation ,COVID-19 ,Cell Biology ,Hematology ,Stem Cell Research ,Regenerative Medicine ,Hematopoietic stem cell ,Oxygen ,Cohort Studies ,Young Adult ,COVID-19 Testing ,Good Health and Well Being ,Clinical Research ,Stem Cell Research - Nonembryonic - Human ,Molecular Medicine ,Immunology and Allergy ,Humans ,Child ,Cancer - Abstract
Adult hematopoietic stem cell transplantation (HSCT) recipients are at a high risk of adverse outcomes after COVID-19. Although children have had better outcomes after COVID-19 compared to adults, data on risk factors and outcomes of COVID-19 among pediatric HSCT recipients are lacking. We describe outcomes of HSCT recipients who were ≤21 years of age at COVID-19 diagnosis and were reported to the Center for International Blood and Marrow Transplant Research between March 27, 2020, and May 7, 2021. The primary outcome was overall survival after COVID-19 diagnosis. We determined risk factors of COVID-19 as a secondary outcome in a subset of allogeneic HSCT recipients. A total of 167 pediatric HSCT recipients (135 allogeneic; 32 autologous HSCT recipients) were included. Median time from HSCT to COVID-19 was 15 months (interquartile range [IQR] 7-45) for allogeneic HSCT recipients and 16 months (IQR 6-59) for autologous HSCT recipients. Median follow-up from COVID-19 diagnosis was 53 days (range 1-270) and 37 days (1-179) for allogeneic and autologous HSCT recipients, respectively. Although COVID-19 was mild in 87% (n=146/167), 10% (n=16/167) of patients required supplemental oxygen or mechanical ventilation. The 45-day overall survival was 95% (95% confidence interval [CI], 90-99) and 90% (74-99) for allogeneic and autologous HSCT recipients, respectively. Cox regression analysis showed that patients with a hematopoietic cell transplant comorbidity index (HCT-CI) score of 1-2 were more likely to be diagnosed with COVID-19 (hazard ratio 1.95; 95% CI, 1.03-3.69, P=.042) compared to those with an HCT-CI of 0. Pediatric and early adolescent and young adult HSCT recipients with pre-HSCT comorbidities were more likely to be diagnosed with COVID-19. Overall mortality, albeit higher than the reported general population estimates, was lower when compared with previously published data focusing on adult HSCT recipients.
- Published
- 2022