Clinical Significance of Human Coronavirus in Bronchoalveolar Lavage Samples From Hematopoietic Cell Transplant Recipients and Patients With Hematologic Malignancies

Ogimi, Chikara; Waghmare, Alpana; Kuypers, Jane; Xie, Hu; Yeung, Cecilia C.S.; Leisenring, Wendy; Seo, Sachiko; Choi, Su‐Mi; Jerome, Keith R.; Englund, Janet A.; Boeckh, Michael

doi:10.1093/cid/cix160

Cited by 72 publications

(83 citation statements)

References 29 publications

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“…In fact, we did not observe significant differences on mortality among the different respiratory viruses in our series, either with or without co‐infections. In addition, our data shows an overall mortality rate (35%) comparable among CARVs and in line with several reports, emphasizing that any CARVs LRTD are still a common life‐threatening complication after allo‐HSCT.…”

Section: Discussionsupporting

confidence: 92%

“…Moreover, all BAL samples were homogenously and prospectively tested for CARVs, fungal, and bacterial agents, avoiding the inclusion of cases with PCR retrospectively tested in frozen BAL samples, and this fact should be considered as strength. Regarding the inclusion of several types of CARVs LRTD, that may differ in their pathogenicity, several comparative studies analyzing mortality among different CARVs LRTD showed similar mortality rates and could justify our pooled cohort analysis for mortality. In fact, we did not observe significant differences on mortality among the different respiratory viruses in our series, either with or without co‐infections.…”

Section: Discussionmentioning

confidence: 82%

“…Some studies have reported that pooled co‐infections (bacteremia, fungal infections, CMV reactivations, herpes simplex virus, human herpesvirus 6, and Epstein‐Barr virus) significantly increased mortality of allo‐HSCT recipients in several CARV types, but others failed to demonstrate such a negative effect . In such reports, there is a lack of comparisons with mono‐infections counterpart.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there is a lack of studies analyzing in detail the incidence, characteristics, and consequences of co‐infective pathogens in the LRT in the setting of CARVs LRTD after allo‐HSCT. Some studies have reported that the presence of co‐infective agents at the time of CARVs LRTD may increase overall mortality . However, it is still unknown to what extent such increase in mortality could only be attributed to the co‐infection by itself or by the aggressiveness of the concurrent co‐infective pathogens.…”

Section: Introductionmentioning

confidence: 99%

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Community‐acquired respiratory virus lower respiratory tract disease in allogeneic stem cell transplantation recipient: Risk factors and mortality from pulmonary virus‐bacterial mixed infections

Piñana

Gómez

Pérez

et al. 2018

Transplant Infectious Dis

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Risk factors (RFs) and mortality data of community-acquired respiratory virus (CARVs) lower respiratory tract disease (LRTD) with concurrent pulmonary co-infections in the setting of allogeneic hematopoietic stem cell transplantation (allo-HSCT) is scarce. From January 2011 to December 2017, we retrospectively compared the outcome of allo-HSCT recipients diagnosed of CARVs LRTD mono-infection (n = 52, group 1), to those with viral, bacterial, or fungal pulmonary CARVs LRTD co-infections (n = 15, group 2; n = 20, group 3, and n = 11, group 4, respectively), and with those having bacterial pneumonia mono-infection (n = 19, group 5). Overall survival (OS) at day 60 after bronchoalveolar lavage (BAL) was significantly higher in group 1, 2, and 4 compared to group 3 (77%, 67%, and 73% vs 35%, respectively, P = .012). Recipients of group 5 showed a trend to better OS compared to those of group 3 (62% vs 35%, P = .1). Multivariate analyses showed bacterial co-infection as a RF for mortality (hazard ratio[HR] 2.65, 95% C.I. 1.2-6.9, P = .017). We identified other 3 RFs for mortality: lymphocyte count <0.5 × 10 /L (HR 2.6, 95% 1.1-6.2, P = .026), the occurrence of and CMV DNAemia requiring antiviral therapy (CMV-DNAemia-RAT) at the time of BAL (HR 2.32, 95% C.I. 1.1-4.9, P = .03), and the need of oxygen support (HR 8.3, 95% C.I. 2.9-35.3, P = .004). CARV LRTD co-infections are frequent and may have a negative effect in the outcome, in particular in the context of bacterial co-infections.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Community‐acquired respiratory virus lower respiratory tract disease in allogeneic stem cell transplantation recipient: Risk factors and mortality from pulmonary virus‐bacterial mixed infections

Piñana

Gómez

Pérez

et al. 2018

Transplant Infectious Dis

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“…Not surprisingly, prospective and retrospective studies of symptomatic cohorts point to higher but variable morbidity and mortality. 28,30,144 As with other RVIs, copathogen detection with HCoV is frequent, 28,30 making interpretation of attributable mortality complicated. That said, there are well-documented cases of severe and even fatal HCoV LRTI in HM patients and HCT recipients.…”

Section: Coronavirusesmentioning

confidence: 99%

Respiratory Virus Infections of the Stem Cell Transplant Recipient and the Hematologic Malignancy Patient

Fontana

Strasfeld

2019

Infectious Disease Clinics of North America

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Respiratory virus infections (RVIs) are increasingly recognized as a cause of significant morbidity and mortality in recipients of hematologic stem cell transplant (HCT) and patients with hematologic malignancy (HM). 1,2 With now widespread use of molecular diagnostics, the epidemiology and spectrum of clinical disease of these infections can be better characterized. Apart from influenza, the currently available antivirals are limited in efficacy and/or associated with potential for toxicity, thus emphasizing the importance of prevention strategies. This article provides a review of the epidemiology, clinical characteristics, management, and prevention of RVIs in HCT recipients and HM patients.No disclosures. KEYWORDS Respiratory virus infection Hematopoietic stem cell transplant RSV Influenza Parainfluenza Human metapneumovirus Rhinovirus Coronavirus KEY POINTSThe morbidity and associated complications of respiratory virus infections are greater in hematopoietic stem cell transplant recipients and patients with hematologic malignancy than in immunocompetent individuals, with severity of illness related to the degree of immunosuppression. Molecular microbiologic testing is the gold standard for diagnosis, allowing differentiation of what are largely overlapping clinical syndromes. Most of the respiratory viruses, apart from influenza and in some circumstances respiratory syncytial virus and adenovirus, are managed supportively. Prevention is key and should focus on vaccination for influenza, avoidance of ill contacts, and compliance with principles of infection control.Infect Dis Clin N Am 33 (2019) 523-544 a Studies are a combination of PCR and traditional laboratory methods (eg, culture, direct fluorescent antibody, and enzyme immunoassay). b PCR-based studies. c Includes all-cause and attributable mortality with variable timeframe to death. d One mortality in a coinfected patient attributed to enterovirus/rhinovirus infection.

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Coronaviruses

Mostafa,

Pinsky

2023

ClinMicroNow

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Coronaviruses (CoVs) are so called due to their striking crown of surface projections, reminiscent of the solar corona, which can be seen by electron microscopy. CoVs have been found in a wide range of domestic and wild mammals and birds; however, the particular diversity of strains found in birds and bats suggests that these animals are the natural reservoirs of CoVs, although this may also be the result of sampling bias. The major transmission route of HCoV is likely to be respiratory, although many animal CoVs also have a fecal‐oral route of transmission and can replicate in epithelial cells in both the respiratory and gastrointestinal tracts. HCoVs can be detected by nucleic acid amplification testing in a range of routine upper and lower respiratory tract specimens, such as nasopharyngeal (NP) swabs, NP aspirates, sputum, and bronchoalveolar lavage fluid.

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Clinical Significance of Human Coronavirus in Bronchoalveolar Lavage Samples From Hematopoietic Cell Transplant Recipients and Patients With Hematologic Malignancies

Abstract: HCoV LRTD in patients with HCT or HM is associated with high rates of oxygen use and mortality. Mortality associated with HCoV LRTD in HCT recipients appears to be similar to that seen with RSV, influenza virus, and PIV.

Cited by 72 publications

References 29 publications

Community‐acquired respiratory virus lower respiratory tract disease in allogeneic stem cell transplantation recipient: Risk factors and mortality from pulmonary virus‐bacterial mixed infections

Community‐acquired respiratory virus lower respiratory tract disease in allogeneic stem cell transplantation recipient: Risk factors and mortality from pulmonary virus‐bacterial mixed infections

Respiratory Virus Infections of the Stem Cell Transplant Recipient and the Hematologic Malignancy Patient

Coronaviruses

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