Epidemiologic and Clinical Characteristics of Coronavirus and Bocavirus Respiratory Infections after Allogeneic Stem Cell Transplantation: A Prospective Single-Center Study

Piñana, José Luís; Madrid, Silvia Christina de Oliveira; Pérez, Ariadna; Hernández‐Boluda, Juan Carlos; Giménez, Estela; Terol, María José; Calabuig, Marisa; Navarro, David; Solano, Carlos

doi:10.1016/j.bbmt.2017.11.001

Cited by 34 publications

(52 citation statements)

References 28 publications

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“…Proven LRTI was defined as when criteria for probable LRTI were met in addition to detection of HCoV in bronchoalveolar lavage (BAL) fluid. These definitions are consistent with guidelines for the diagnosis of respiratory virus infections in patients with leukemia and HSCT recipients, as well as definitions used in prior studies of HCoV infections in HSCT recipients (3,13). Respiratory failure was defined as the need for mechanical ventilation within 30 days of isolating the virus or respiratory failure listed as the primary cause of death within 30 days of virus detection.…”

Section: Definitionsmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

“…The four most common HCoV serotypes are OC43, HKU1, NL63, and 229E [2,3]. These four strains most commonly cause classic "common cold" infectious symptoms in immunocompetent individuals [3]. In HSCT recipients, however, the incidence of post-transplant infection, symptomatology, risk of and risk factors for progression to lower respiratory tract infection (LRTI) and respiratory failure are largely unknown.…”

Section: Introductionmentioning

confidence: 99%

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Incidence, significance, and persistence of human coronavirus infection in hematopoietic stem cell transplant recipients

Eichenberger

Soave

Zappetti

et al. 2018

Bone Marrow Transplant

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Hematopoietic stem cell transplant (HSCT) recipients are at increased risk of respiratory viral infections and their associated complications. Unlike other respiratory viruses, little is known about the clinical significance of human coronavirus infection (HCoV) in this population. We retrospectively identified all HSCT recipients who were transplanted between May 2013 and June 2017 at our institution and characterized the cumulative incidence of post-transplant HCoV infection. Of 678 patients who underwent HSCT during the study period, 112 (17%) developed HCoV infection, making HCoV the fourth most common respiratory viral infection. Thirty-four (30%) HCoV-infected patients progressed to proven or probable lower respiratory tract infection (LRTI). Age ≥50, graft-versus-host disease, corticosteroids, hypoalbuminemia, and inpatient status at the time of infection were independently associated with progression to LRTI. Twenty-seven (59%) patients who underwent repeat NP swab had persistent viral shedding for ≥21 days, with a median duration of 4 weeks of viral shedding. We conclude that HCoV is common and clinically significant in HSCT recipients, with nearly one-third of patients progressing to proven or probable LRTI. Evaluating for LRTI risk factors found in this study may identify patients who require closer surveillance and aggressive supportive care when infected with HCoV.

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Section: Definitionsmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence, significance, and persistence of human coronavirus infection in hematopoietic stem cell transplant recipients

Eichenberger

Soave

Zappetti

et al. 2018

Bone Marrow Transplant

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“…Disease severity was not substantial, with only 1 case of LRTI, which was believed likely caused by enterovirus/rhinovirus and no deaths from respiratory failure in the 6 affected patients. 28 Viral dissemination has been documented in transplant recipients, with detection of HBoV in blood and stool. 142 Given the frequency of coinfection and the mild disease severity, many questions remain regarding the pathogenic potential of HBoV in HCT recipients and other immunocompromised hosts.…”

Section: Bocavirusmentioning

confidence: 99%

“…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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Can COVID‐19 cause severe neutropenia?

Lopez‐Pereira

Iturrate

Cámara

et al. 2020

Clinical Case Reports

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) produces a broad spectrum of respiratory symptoms, from mild to pneumonia and acute respiratory distress syndrome. Coronavirus disease (COVID-19) is associated with an inflammatory syndrome that may increase damage to the lungs. Several hematopoietic and hemostatic abnormalities have been described, as well as autoimmune disorders. 1,2 2 | CASE HISTORY We report a 33-year-old woman, a surgical nurse, with no relevant medical history (although her sister was diagnosed with Hodgkin lymphoma), who was admitted to the Hematology Department at our hospital with severe neutropenia, asthenia, and enlarged lymph nodes 11 days after being diagnosed with COVID-19. On April 1, the patient presented at her family doctor (FD) with a sore throat, asthenia, and myalgia. SARS-CoV-2 polymerase chain reaction revealed positivity on oropharyngeal swabs obtained by the FD on April 2. She did not receive antiviral treatment, only acetaminophen when needed, and was discharged to her home to remain in isolation. Initially, her symptoms improved, but on April 13, she presented to the emergency department because of asthenia, gum swelling, and chills without fever or respiratory symptoms, such as shortness of breath or cough. Her vital signs, including oxygen saturation, were normal, and physical examination showed mild enlargement of the cervical, axillary, and inguinal lymph nodes without other pathological findings. 2.1 | Investigations and treatment Blood counts showed mild leukopenia (3.07 × 10 9 /L) with severe neutropenia (0.33 × 10 9 /L) and eosinopenia (0.05 × 10 9 /L) with a normal lymphocyte count, hemoglobin level, and platelet count. No morphological abnormalities were observed in the peripheral blood smear. Blood biochemistry assessment showed an increased level of C-reactive protein (2.51 mg/dL; normal, <0.5 mg/dL). Her lactate dehydrogenase level, liver function, and renal function were normal. Her interleukin-6 level was 20 pg/mL (normal, <7 pg/ mL). She had a fibrinogen level of 603 mg/dL with a normal D-dimer level. Her chest radiography was normal, and the pregnancy test result was negative. A new oropharyngeal swab for the SARS-CoV-2 test was performed on April 14, which continued to show positivity.

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Epidemiologic and Clinical Characteristics of Coronavirus and Bocavirus Respiratory Infections after Allogeneic Stem Cell Transplantation: A Prospective Single-Center Study

Cited by 34 publications

References 28 publications

Incidence, significance, and persistence of human coronavirus infection in hematopoietic stem cell transplant recipients

Incidence, significance, and persistence of human coronavirus infection in hematopoietic stem cell transplant recipients

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

Can COVID‐19 cause severe neutropenia?

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