Impact of COVID-19 in Hematopoietic stem cell transplant recipients: A systematic review and meta-analysis.
Transpl Infect Dis 2022;
24:e13792. [PMID:
35030267 DOI:
10.1111/tid.13792]
[Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/23/2021] [Accepted: 01/03/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND
Hematopoietic stem cell transplant (HSCT) recipients are at increased risk of mortality and morbidity with Coronavirus Disease 2019 (COVID-19) due to severe immune dysfunction.
METHODS
A literature search was performed on PubMed, Cochrane, and Clinical trials.gov from the date of inception to 12/08/2021. We identified 19 original studies reporting data on COVID-19 in HSCT recipients after screening 292 articles. Data was extracted following PRISMA guidelines. Quality evaluation was done using the NIH quality assessment tool. Inter-study variance was calculated using Der Simonian-Laird Estimator. Pooled analysis was conducted using MetaXL. A random-effects model was used to estimate the proportions with 95% confidence intervals (CI).
RESULTS
Of 6711 patients in 19 studies, 2031 HSCT patients with SARS-CoV-2 infection were analyzed. The median age of patients was 56.9 (range 1-81.6) years, and 63% patients were men according to 14 studies. The median time from transplant to SARS-CoV-2 infection for autologous (auto) and allogeneic (allo) HSCT patients was 23.2 (0.33- 350.5) months and 16.4 (0.2- 292.7) months respectively. The median follow-up time after COVID-19 diagnosis was 28 (0-262) days. The COVID-19 mortality rate was 19% (95% CI 0.15- 0.24, I2 = 76%, n = 373/2031). The pooled mortality rate was 17% (95% CI 0.12- 0.24, I2 = 78%, n = 147/904) in auto-HSCT patients and 21% (95% CI 0.16- 0.25, I2 = 60%, n = 231/1103) in allo-HSCT patients.
CONCLUSIONS
HSCT recipients have a high risk of mortality and clinical complications due to COVID-19. There is a need for ongoing vigilance, masks, and social distancing, vaccination, and aggressive management of SARS-CoV-2 infection in HSCT recipients. This article is protected by copyright. All rights reserved.
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