Coronavirus infection after blood stem cell transplantation
E. Yu. Grishina,
E. N. Misyurina,
E. I. Zhelnova,
E. A. Baryakh,
K. V. Yatskov,
A. B. Makeshova,
E. A. Karimova,
E. N. Zotina, 
D. E. Gagloeva,
V. N. Yakimets,
M. A. Mingalimov,
T. N. Tolstykh,
Yu. Yu. Polyakov,
T. S. Chudnova,
O. L. Kochneva,
L. T. Shimanovskaya
D. E. Gagloeva,
V. N. Yakimets,
M. A. Mingalimov,
T. N. Tolstykh,
Yu. Yu. Polyakov,
T. S. Chudnova,
O. L. Kochneva,
L. T. Shimanovskaya https://doi.org/10.17650/1818-8346-2023-18-4(Suppl)-91-95
Abstract
Background. In March 2020, oncohematologists faced the problem of severe COVID-19 coronavirus infection in patients after a high-dose chemotherapy and autologous or allogeneic bone marrow transplantation. This required a review of issues related to the selection of patients for blood stem cell transplantation (HSCT), the development of new preventive and therapeutic tactics aimed at treating infectious and immunological complications in patients of this category, depending on the nature and status of the underlying disease and the timing of treatment.
Aim. To assess the severity, most typical complications and course of COVID-19 in patients during early and late posttransplant periods.
Materials and methods. We analyzed the data of patients after HSCT with active coronavirus infection hospitalized in the hematology department from 2020 to 2021. A total of 25 patients were hospitalized: 4 after allogeneic transplantation, 21 after autologous transplantation. According to the timing of HSCT, patients were divided into 2 groups: early period (ETP) (2-90 days after HSCT) - 14 patients, late period (LTP) (3-24 months after HSCT) - 11 patients.
Results. Severe coronavirus infection (grades III-IV according to computed tomography) was more often observed in patients in the ETP group (65 %) than in the LTP group (18 %). The incidence of respiratory failure was 70 and 36 % in the ETP and LTP groups, respectively. In the ETP group, agranulocytosis and the development of severe infectious complications (bacterial, fungal and viral) were observed significantly more often than in the LTP group, which required the appointment of reserve groups antibacterial therapy and antifungal therapy. Mortality in the ETP group was 35 %, while no deaths were recorded in the LTP group. The median duration of hospitalization for patients in the ETP and LTP groups was 20 and 13 days, respectively.
Conclusion. Patients early after HSCT are at higher risk of developing lower respiratory tract infections, are more likely to require hospitalization in the intensive care unit, and have a greater risk of death from COVID-19. Therapy with genetically engineered biological drugs is not contraindicated in the case of leukopenia and agranulocytosis in this group of patients.
About the Authors
E. Yu. Grishina
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
Ekaterina Yu. Grishina.
3 Pekhotnaya St., Moscow 123182
E. N. Misyurina
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
E. I. Zhelnova
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
E. A. Baryakh
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University); Russian Medical Academy of Continuing Professional Education, Ministry of Health of Russia; N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991; Build. 1, 2 / 1 Barrikadnaya St., Moscow 125993; 1 Ostrovityanova St., Moscow 117997
K. V. Yatskov
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182
A. B. Makeshova
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
E. A. Karimova
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182
E. N. Zotina
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
D. E. Gagloeva
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
V. N. Yakimets
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182
M. A. Mingalimov
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
T. N. Tolstykh
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
Yu. Yu. Polyakov
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
T. S. Chudnova
City Clinical Hospital No. 52, Moscow Healthcare Department; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182; Build. 2, 8 Trubetskaya St., Moscow 119991
O. L. Kochneva
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182
L. T. Shimanovskaya
City Clinical Hospital No. 52, Moscow Healthcare Department
Russian Federation
Russian Federation
3 Pekhotnaya St., Moscow 123182
References
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Review
For citations:
Grishina E.Yu., Misyurina E.N., Zhelnova E.I., Baryakh E.A., Yatskov K.V., Makeshova A.B., Karimova E.A., Zotina E.N., Gagloeva D.E., Yakimets V.N., Mingalimov M.A., Tolstykh T.N., Polyakov Yu.Yu., Chudnova T.S., Kochneva O.L., Shimanovskaya L.T. Coronavirus infection after blood stem cell transplantation. Oncohematology. 2023;18(4):91-95. (In Russ.) https://doi.org/10.17650/1818-8346-2023-18-4(Suppl)-91-95
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