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Clinical characteristics and outcomes of allogeneic hematopoietic stem cell transplantation recipients with coronavirus disease 2019 caused by the Omicron variant: a prospective, observational cohort study

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Abstract

We aimed to describe the clinical characteristics, particularly the occurrence and risk factors of severe/critical illness, in allogeneic hematopoietic stem cell (allo-HSCT) recipients infected with coronavirus disease 2019 (COVID-19) caused by Omicron variant in an observational prospective study (n = 311). The median time from allo-HSCT to COVID-19 diagnosis was 8.5 months (range 0.8–106.1) months. Four patients (1.3%) were reported to be asymptomatic during Omicron variant infection, and 135 (43.4%) patients showed lower respiratory tract disease. Thirty-four (10.9%) patients were categorized into serious infection (severe illness n = 25; critical illness n = 9) and the median duration from COVID-19 diagnosis to serious infections was 6 days (range, 0–29) days. Thirteen (4.2%) and 6 (1.9%) patients required intensive care unit care and invasive mechanical ventilation, respectively. Receiving more than 1 type of immunosuppressive therapies at COVID-19 diagnosis was associated with severity and persistence of infection. Six patients (1.9%) died after diagnosis of COVID-19 infection. The 4-week probability of overall survival after COVID-19 diagnosis was 98.7%, which was 100% and 88.2% for non-serious and serious infection group (P < 0.001), respectively. Thus, we observed a relatively low serious infection and mortality rate in allo-HSCT recipients infected with COVID-19 caused by Omicron variant.

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Data availability

The dataset supporting the conclusions of this article is available in the clinical data repository of Peking University People’s Hospital. Individual participant data were not shared. For the original data, please contact moxiaodong@pkuph.edu.cn.

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Acknowledgements

The authors appreciate Dr. Wen-Xuan Huo, Ze Guo, Qi Wen, Meng-Zhu Shen, and Ze-Hua Wu for their help in data collection. This work was supported by the National Key Research and Development Program of China (Nos. 2022YFA1103300 and 2022YFC2502606), Major Program of the National Natural Science Foundation of China (No. 82293630), the Key Program of the National Natural Science Foundation of China (No. 81930004), the National Natural Science Foundation of China (No. 82170208), CAMS Innovation Fund for Medical Sciences (No. 2019-I2M-5-034, 2022-I2M-C&T-B-121), and the Fundamental Research Funds for the Central Universities.

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  1. Shuang Fan and Xiaodong Mo contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Peking University People’s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China

    Shuang Fan, Xiaodong Mo, Xiaohui Zhang, LanPing Xu, Yu Wang, Chenhua Yan, Huan Chen, Yuanyuan Zhang, Yifei Cheng, Yuqian Sun, Yuhong Chen, Yao Chen, Wei Han, Jingzhi Wang, Fengrong Wang, Zhengli Xu & Xiaojun Huang

  2. Research Unit of Key Technique for Diagnosis and Treatments of Hematologic Malignancies, Chinese Academy of Medical Sciences, Beijing, 2019RU029, China

    Xiaodong Mo & Xiaojun Huang

  3. Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China

    Xiaojun Huang

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Contributions

Xiaojun Huang designed the study. Xiaohui Zhang, LanPing, Yu Wang, Chenhua Yan, Huan Chen, Yuanyuan Zhang, Yifei Cheng, Yuqian Sun, Yuhong Chen, Yao Chen, Wei Han, Jingzhi Wang, Fengrong Wang, and Zhengli Xu conducted data collection and manuscript preparation. Xiaodong Mo and Shuang Fan conducted data analysis, statistical analysis, and manuscript editing.

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Correspondence to Xiaojun Huang.

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The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Institutional Review Board of Peking University People’s Hospital.

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One of the authors, Xiaojun Huang, serves as the editor of AOH. The other authors declare no competing interests.

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Fan, S., Mo, X., Zhang, X. et al. Clinical characteristics and outcomes of allogeneic hematopoietic stem cell transplantation recipients with coronavirus disease 2019 caused by the Omicron variant: a prospective, observational cohort study. Ann Hematol 103, 1333–1344 (2024). https://doi.org/10.1007/s00277-024-05653-8

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