The Reality of Hematopoietic Stem Cell Transplantation in a Pandemic: How Has COVID-19 Impacted Graft-versus-Host Disease and Mortality?

OpenAlex İngilizce

Introduction: Coronavirus diseases-2019 (COVID-19) has been associated with significant morbidity and mortality, particularly in immunosuppressed patients.This study aimed to evaluate the incidence, clinical course, and outcomes of COVID-19 in patients who underwent hematopoietic stem cell transplantation (HSCT) during the pandemic, and to compare long-term outcomes of transplants performed before and during the pandemic. Materials and Methods: A total of 193 patients who underwent HSCT at Ankara Bilkent City Hospital between 2016 and 2021 were retrospectively analyzed. The primary outcome was 30-day mortality after COVID-19 diagnosis. Secondary outcomes included one-year mortality, graft-versus-host disease (GVHD), relapse, progression, and recurrence.Results: Of the patients, 64.8% were male, with a mean age of 58.8 years.Autologous HSCT was performed in 81.3% and allogeneic HSCT in 18.7%.COVID-19 was diagnosed in 30.6% of patients, of whom 61.9% were asymptomatic.Hospitalization and intensive care unit admission rates were 31% and 7.1%, respectively.Oxygen therapy was required in 11.9% and mechanical ventilation in 2.4%.The vaccination rate was 24.5%, and the 28-day mortality following COVID-19 was 2.2%.No significant differences were observed between the pre-pandemic and pandemic transplant groups regarding demographic characteristics, hospitalization, or treatment.Although patients transplanted during the pandemic appeared to have higher rates of chemotherapy delay (100% vs. 66.7%),GVHD (39.1% vs. 30.8%),and one-year mortality (3.75% vs. 0%), these differences were not statistically significant (p> 0.05 for all comparisons).Conclusion: COVID-19-related severe illness and mortality rates were low among HSCT recipients.Nevertheless, patients transplanted during the pandemic appeared to have worse prognoses, warranting closer monitoring and further investigation.These findings may help guide transplantation practices during future infectious disease outbreaks.