Seasonal Human Coronavirus Respiratory Tract Infection in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation
Jose Luis Piñana, Aliénor Xhaard, Gloria Tridello, Jakob Passweg, A.E. Kozijn, Nicola Polverelli, Inmaculada Heras, Ariadna Pérez, Jaime Sanz, Dagmar Berghuis, Lourdes Vázquez, María Suárez‐Lledó, Maija Itälä‐Remes, Tülay Özçelik, Isabel Iturrate, Musa Karakükçü, Mohsen Al Zahrani, Goda Choi, Marián Angeles Cuesta Casas, Montserrat Batlle Massana, Viviana Amato, Nicole M. A. Blijlevens, Arnold Ganser, Barış Kuşkonmaz, Hélène Labussière‐Wallet, Peter J. Shaw, Zeynep Arzu Yeğin, Marta González‐Vicent, Vanderson Rocha, Alina Ferster, Nina Knelange, David Navarro, Małgorzata Mikulska, Rafael de la Cámara, Jan Styczyński
Abstract
BACKGROUND: Little is known about characteristics of seasonal human coronaviruses (HCoVs) (NL63, 229E, OC43, and HKU1) after allogeneic stem cell transplantation (allo-HSCT). METHODS: This was a collaborative Spanish and European bone marrow transplantation retrospective multicenter study, which included allo-HSCT recipients (adults and children) with upper respiratory tract disease (URTD) and/or lower respiratory tract disease (LRTD) caused by seasonal HCoV diagnosed through multiplex polymerase chain reaction assays from January 2012 to January 2019. RESULTS: We included 402 allo-HSCT recipients who developed 449 HCoV URTD/LRTD episodes. Median age of recipients was 46 years (range, 0.3-73.8 years). HCoV episodes were diagnosed at a median of 222 days after transplantation. The most common HCoV subtype was OC43 (n = 170 [38%]). LRTD involvement occurred in 121 episodes (27%). HCoV infection frequently required hospitalization (18%), oxygen administration (13%), and intensive care unit (ICU) admission (3%). Three-month overall mortality after HCoV detection was 7% in the whole cohort and 16% in those with LRTD. We identified 3 conditions associated with higher mortality in recipients with LRTD: absolute lymphocyte count <0.1 × 109/mL, corticosteroid use, and ICU admission (hazard ratios: 10.8, 4.68, and 8.22, respectively; P < .01). CONCLUSIONS: Seasonal HCoV after allo-HSCT may involve LRTD in many instances, leading to a significant morbidity.