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COVID-19 in hematopoietic stem cell transplant recipients during three years of the pandemic: a multicenter study in Brazil.
Randi, Bruno Azevedo; Higashino, Hermes Ryoiti; Silva, Vinícius Ponzio da; Salomão, Matias Chiarastelli; Pignatari, Antonio Carlos Campos; Abdala, Edson; Vasques, Fabiana; Silva, Celso Arrais Rodrigues da; Silva, Roberto Luiz da; Lazari, Carolina Dos Santos; Levi, José Eduardo; Xavier, Erick Menezes; Côrtes, Marina Farrel; Luna-Muschi, Alessandra; Rocha, Vanderson; Costa, Silvia Figueiredo.
Afiliación
  • Randi BA; Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil.
  • Higashino HR; Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil.
  • Silva VPD; Hospital 9 de Julho, Dasa, São Paulo, São Paulo, Brazil.
  • Salomão MC; Hospital 9 de Julho, Dasa, São Paulo, São Paulo, Brazil.
  • Pignatari ACC; Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, São Paulo, Brazil.
  • Abdala E; Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil.
  • Vasques F; Hospital 9 de Julho, Dasa, São Paulo, São Paulo, Brazil.
  • Silva CARD; Hospital 9 de Julho, Dasa, São Paulo, São Paulo, Brazil.
  • Silva RLD; Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, São Paulo, Brazil.
  • Lazari CDS; Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Moléstias Infecciosas e Parasitárias, São Paulo, São Paulo, Brazil.
  • Levi JE; Hospital 9 de Julho, Dasa, São Paulo, São Paulo, Brazil.
  • Xavier EM; Hospital 9 de Julho, Dasa, São Paulo, São Paulo, Brazil.
  • Côrtes MF; Hospital 9 de Julho, Dasa, São Paulo, São Paulo, Brazil.
  • Luna-Muschi A; Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, São Paulo, Brazil.
  • Rocha V; Hospital 9 de Julho, Dasa, São Paulo, São Paulo, Brazil.
  • Costa SF; Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Laboratório Central, São Paulo, São Paulo, São Paulo, Brazil.
Rev Inst Med Trop Sao Paulo ; 66: e17, 2024.
Article en En | MEDLINE | ID: mdl-38511806
ABSTRACT
Hematopoietic stem cell transplant (HSCT) recipients are at -increased risk for severe COVID-19. The aim of this study was to evaluate the burden of COVID-19 in a cohort of HSCT recipients. This retrospective study evaluated a cohort of adult hospitalized HSCT recipients diagnosed with COVID-19 in two large hospitals in São Paulo, Brazil post-HSCT, from January 2020 to June 2022. The primary outcome was all-cause mortality. Of 49 cases, 63.2% were male with a median age of 47 years. Allogeneic-HSCT (51.2%) and autologous-HSCT (48.9%) patients were included. The median time from HSCT to COVID-19 diagnosis was 398 days (IQR 1211-134), with 22 (44.8%) cases occurring within 12 months of transplantation. Most cases occurred during the first year of the pandemic, in non-vaccinated patients (n=35; 71.4%). Most patients developed severe (24.4%) or critical (40.8%) disease; 67.3% received some medication for COVID-19, primarily corticosteroids (53.0%). The probable invasive aspergillosis prevalence was 10.2%. All-cause mortality was 40.8%, 51.4% in non-vaccinated patients and 14.2% in patients who received at least one dose of the vaccine. In the multiple regression analyses, the variables mechanical ventilation (OR 101.01; 95% CI 8.205 - 1,242.93; p = 0.003) and chest CT involvement at diagnosis ≥50% (OR 26.61; 95% CI 1.06 - 664.26; p = 0.04) remained associated with all-cause mortality. Thus, HSCT recipients with COVID-19 experienced high mortality, highlighting the need for full vaccination and infection prevention measures.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Células Madre Hematopoyéticas / COVID-19 Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Brasil Idioma: En Revista: Rev Inst Med Trop Sao Paulo Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Brasil
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Células Madre Hematopoyéticas / COVID-19 Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Brasil Idioma: En Revista: Rev Inst Med Trop Sao Paulo Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Brasil