The clinical course of the novel coronavirus disease in children after allogeneic hematopoietic stem cell transplantation

Cover Page

Cite item

Full Text

Abstract

The clinical course of the novel coronavirus disease (COVID-19) in patients with oncological and hematological diseases after hematopoietic stem cell transplantation (HSCT), are of special interest. To further investigate the problem, a two-center study was undertaken at the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology and the R.M. Gorbacheva National Research Institute for Pediatric Oncology, Hematology and Transplantation between January 2020 and January 2023. This was a retrospective-prospective, non-randomized, non-interventional study that included children aged 0–19 years with oncological and hematological diseases and primary immunodeficiencies who had undergone allogeneic HSCT and subsequently contracted COVID-19. The study was approved by the Independent Ethics Committee and the Scientific Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology. COVID-19 cases were confirmed by polymerase chain reaction testing and classified as asymptomatic, mild, moderate, severe, and critical. The study included 105 patients with a median age of 9 years; male patients were predominant (the male-to-female ratio was 1.8:1). The primary diseases were hematological malignancies (73%), benign hematological diseases (14%) and primary immunodeficiencies (13%). The most common clinical symptoms of COVID-19 were fever, gastrointestinal symptoms, and respiratory symptoms; 40% of COVID-19 cases were asymptomatic. Lymphopenia was found to be a risk factor for severe COVID-19. The patients without immune reconstitution had a longer persistence of the COVID-19 virus than those with immune reconstitution (17 days versus 13 days), however, no significant differences were obtained (p = 0.7). There were also no significant differences in the severity and outcomes of COVID-19 between the patients with immune reconstitution and those without reconstitution. There was no effect of therapy on the duration of COVID-19, and there was no association between the type of treatment and the duration of the disease. The overall survival rate in the allo-HSCT recipients who had been diagnosed with COVID-19 was 88%, which was lower than in the non-recipients (88% vs 94%; p = 0,077).

About the authors

A. O. Vereshchagina

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

Author for correspondence.
Email: a.vereshchagina@dgoi.ru
ORCID iD: 0000-0001-5606-4335

Anastasia O. Vereshchagina, a hematologist at the Department of Infection Control 

1 Samory Mashela St., Moscow 117997, Russia

Russian Federation

G. G. Solopova

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0002-1680-7269

Moscow

Russian Federation

T. A. Bykova

R.M. Gorbacheva Research Institute for Pediatric Oncology, Hematology and Transplantation of the I.P. Pavlov First Saint Petersburg State Medical University of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0002-4456-2369

Saint-Petersburg

Russian Federation

M. O. Popova

R.M. Gorbacheva Research Institute for Pediatric Oncology, Hematology and Transplantation of the I.P. Pavlov First Saint Petersburg State Medical University of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0001-8536-5495

Saint-Petersburg

Russian Federation

D. N. Balashov

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0003-2689-0569

Moscow

Russian Federation

N. V. Suvorova

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0009-0009-6291-8849

Moscow

Russian Federation

E. V. Rozanceva

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0002-5269-5508

Moscow

Russian Federation

P. A. Levin

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0002-2410-1223

Moscow

Russian Federation

L. S. Zubarovskaya

R.M. Gorbacheva Research Institute for Pediatric Oncology, Hematology and Transplantation of the I.P. Pavlov First Saint Petersburg State Medical University of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0003-2594-7703

Saint-Petersburg

Russian Federation

G. A. Novichkova

Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation

ORCID iD: 0000-0002-2322-5734

Moscow

Russian Federation

References

  1. World Health Organization. Coronavirus disease (COVID-19) pandemic. [Electronic resource] URL: https://www.who.int/emergencies/diseases/novel-coronavirus-2019; 2023 (accessed 13 April 2023).
  2. Vardavas C.I., Mathioudakis A.G., Nikitara K., Stamatelopoulos K., Georgiopoulos G., Phalkey R., et al. Prognostic factors for mortality, intensive care unit and hospital admission due to SARS-CoV-2: a systematic review and meta-analysis of cohort studies in Europe. Eur Respir Rev 2022; 31 (166): 220098. doi: 10.1183/16000617.0098-2022
  3. Ryan L. Vaccinated but not protected-living immunocompromised during the pandemic. JAMA 2021; 325 (24): 2443–4. DOI: 10.1001/ jama.2021.9321
  4. Balashov D., Trakhtman P., Livshits A., Kovalenko I., Tereshenko G., Solopova G., et al. SARS-CoV-2 convalescent plasma therapy in pediatric patient after hematopoietic stem cell transplantation. Transfus Apher Sci 2021; 60 (1): 102983.
  5. Prevention, diagnosis and treatment of the novel coronavirus infection (COVID-19). Temporary guidelines of the Ministry of Healthcare of the Russian Federation. Version 8 dated 03.09.2020 [Electronic resource] URL: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/051/777/original/030902020_COVID-19_v8.pdf. (Access date 14.04.2024). (In Russ.).
  6. Leontyeva M.E., Sultanova E.R., Radygina S.A., Skvortsova Yu.V., Muzalevskiy Ya.O., Kurnikova E.E., et al. The use of adoptive cell therapy for the treatment of SARS-CoV-2 in a patient after allogeneic hematopoietic stem cell transplantation. Pediatric Hematology/Oncology and Immunopathology 2022; 21 (2): 112–7. (In Russ.).
  7. Haesler G.M., Amman R.A., Carlesse F., Groll A.H., Averbuch D., Costagnola E., et al. SARS-CoV-2 in children with cancer or following haematopoietic stem cell transplant: an analysis of 131 patients. Eur J Cancer 2021; 159: 78–86.
  8. Lu Y., Li Y., Deng W., Liu M., He Y., Huang L., et al. Symptomatic infection is associated with prolonged duration of viral shedding in mild coronavirus disease 2019: a retrospective study of 110 children in Wuhan. Pediatr Infect Dis J 2020; 39 (7): е95–9.
  9. Sharma A., Bhatt N.S., St Martin A., Abid M.B., Bloomquist J., Chemaly R.F., et al. Clinical characteristics and outcomes of COVID-19 in haematopoietic stem-cell transplantation recipients: an observational cohort study. Lancet Haematol 2021; 8: e185–93. doi: 10.1016/S2352-3026(20)30429-4
  10. Pagano L., Salmanton-García J., Marchesi F., Busca A., Corradini P., Hoenigl M., et.al. EPICOVIDEHA working group. COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA). J Hematol Oncol 2021; 14 (1): 168. doi: 10.1186/s13045-02101177-0
  11. Ljungman P., de la Camara R., Mikulska M., Tridello G., Aguado B., Al Zahrani M., et al. COVID-19 and stem cell transplantation; results from an EBMT and GETH multicenter prospective survey. Leukemia 2021; 35: 2885–94. doi: 10.1038/s41375-02101302-5
  12. Aleshina O., Zakurdaeva K., Vasileva A., Dubov S., Dubov V., Vorobyev V., et al. Clinical outcomes in patients with COVID-19 and hematologic disease. [Electronic resource] URL: https://pubmed.ncbi.nlm.nih.gov/?term=Samoylova%20OS%5BAuthor%5D (accessed 14.04.2024).
  13. Lu X., Zhang L., Du H., Jiang Zh., Li Y., Qu J., et al. SARS‐CoV‐2 infection in children. N Engl J Med 2020; 382: 1663–5. (accessed 13 April 2023).
  14. Kuczborska K., Książ J. Prevalence and Course of SARS-CoV-2 Infection among Immunocompromised Children Hospitalised in the Tertiary Referral Hospital in Poland. J Clin Med 2021; 10 (19): 4556. doi: 10.3390/jcm10194556
  15. Ji L.-N., Chao S., Wang Y.-J., Li X.-J., Mu X.-D., Lin M.-G., et al. Clinical features of pediatric patients with COVID-19: a report of two family cluster cases. World J Pediatr 2020; 16 (3): 267–70.
  16. Wei M., Yuan J., Liu Y., Fu T., Yu X., Zhang Z.-J. Novel coronavirus infection in hospitalized infants under 1 year of age in China. JAMA 2020; 323: 1313–4.
  17. Connelly J.A., Chong H., Esbenshade A.J., Frame D., Failing С., Secord Е., Walkovich K. Impact of COVID-19 on Pediatric Immunocompromised Patients. Pediatr Clin North Am 2021; 68 (5): 1029–54.
  18. Averbuch D., De La Camara R., Corbacioglu S., Mikulska M., Piñana Sanchez J.L.? et al. COVID-19 in Children Following Hematopoietic Cell Transplantation: A Multinational Study of the European Bone Marrow Transplantation Society (EBMT) and the Spanish Group of Hematopoietic Stem Cell Transplantation (GETH). Blood 2021; 138 (S1): 2866. doi: 10.1182/blood-2021-146748
  19. Siniaev A.A., Grinenko A.O., Popova M.O., Rogacheva Yu.A., Spiridonova A.A., Vlasova Yu.Yu., et al. COVID-19 infection in hematopoietic stem cell transplant recipients. Clinical Microbiology and Antimicrobial Chemotherapy 2022; (3): 196–201. (In Russ.).doi: 10.36488/cmac.2022.3.196-201
  20. Solopova G.G., Tsyganova E.V., Kondrashova A.V., Gordeeva G.N., Rozanceva E.V., Begunova S.V., et al. The novel coronavirus disease (COVID-19) in children with cancer, hematologic malignancies, and severe immunodeficiencies. Results of monocenter study. Pediatric Hematology/Oncology and Immunopathology 2021; 20 (4): 89–99. (In Russ.) doi: 10.24287/17261708-2021-20-4-89-99
  21. Haeusler G.M., Ammann R.A., Carlesse F., Groll A.H., Averbuch D., Castagnola E., et al. SARS-CoV-2 in children with cancer or after haematopoietic stem cell transplant: An analysis of 131 patients. Eur J Cancer 2021; 159: 78–86.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2025 Vereshchagina A.O., Solopova G.G., Bykova T.A., Popova M.O., Balashov D.N., Suvorova N.V., Rozanceva E.V., Levin P.A., Zubarovskaya L.S., Novichkova G.A.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.