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Prior COVID-19 infection may increase risk for developing endothelial dysfunction following hematopoietic cell transplantation

Authors :
Sydney Ariagno
Dristhi Ragoonanan
Sajad Khazal
Kris M. Mahadeo
Gabriel Salinas Cisneros
Matt S. Zinter
Robyn A. Blacken
Gopi Mohan
Leslie E. Lehmann
Asmaa Ferdjallah
Kristin C. Mara
Mira A. Kohorst
Source :
Frontiers in Oncology, Vol 12 (2023)
Publication Year :
2023
Publisher :
Frontiers Media S.A., 2023.

Abstract

Endothelial dysfunction underlies many of the major complications following hematopoietic cell transplantation (HCT), including transplant-associated thrombotic microangiopathy (TA-TMA), veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS), and engraftment syndrome (ES). Emerging evidence similarly implicates endothelitis and microangiopathy in severe COVID-19-related multi-system organ dysfunction. Given the overlap in these two illness states, we hypothesize that prior COVID-19 infection may increase risk for HCT-related endotheliopathies. This retrospective, multicenter study included patients aged 0-25 years who underwent autologous or allogeneic HCT for any indication between January 1, 2020 and September 21, 2021, with close attention to those infected with COVID-19 in either the six months prior to transplant or twelve months following transplant. Incidences of TA-TMA, VOD/SOS, and ES were compared among patients with COVID-19 infection pre-HCT and post-HCT, as well as with historical controls who were never infected with SARS-CoV-2. Those who underwent HCT following COVID-19 infection displayed significantly increased rates of TA-TMA compared to those who were never infected. Additionally, our data suggests a similar trend for increased VOD/SOS and ES rates, although this did not reach statistical significance. Therefore, a history of COVID-19 infection prior to undergoing HCT may be a nonmodifiable risk factor for endothelial-related complications following HCT. Further studies are warranted to better clarify this relationship among larger cohorts and in the era of the Omicron SARS-CoV-2 variants.

Details

Language :
English
ISSN :
2234943X
Volume :
12
Database :
Directory of Open Access Journals
Journal :
Frontiers in Oncology
Publication Type :
Academic Journal
Accession number :
edsdoj.fc05838b5e864dd8a37c73d98de0f219
Document Type :
article
Full Text :
https://doi.org/10.3389/fonc.2022.1000215