Characteristics and Outcomes of Stem Cell Transplant Patients during the COVID-19 Era: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Literature Search Engines and Terms Used
2.2. Study Types Selected and Inclusion Criteria
2.3. Data Extraction and Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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n | ||||||||
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Author-Year | Type of Article | All Patients | SCT Recipients with COVID-19 | Mean Age, Years | Male Patients | Cancer Type | Type of Transplant | Transplant to COVID-19 Infection Time |
Dufour 2020 [27] | Letter to the editor | 20 | 8 | NA | NA | MM | Auto | 7 years |
Vicent 2020 [28] | Letter to the editor | 8 | 8 | 9.25 | 7 | Primary immunodeficiency, MDS, ALL, AML | Allo | 1 month–2 years (median, 18 months) |
Nazon 2020 [29] | Case report | 1 | 1 | 17.00 | NA | AML-M5 | Allo | NA |
Rossof 2020 [30] | Case series | 6 | 1 | 5.00 | 0 | AML | Allo | NA |
De Giorgi 2020 [31] | Case report | 1 | 1 | 33.00 | 1 | Testicular germ cell tumor | Auto | 6 |
Bisogno 2020 [32] | Case series | 29 | 3 | NA | NA | JMML, ALL, and HL | Allo (n = 3 [100%]) | 5, 9, and 22 months |
Onaka 2020 [33] | Case report | 1 | 1 | 61.00 | 1 | Transformed follicular lymphoma | Allo | 205 |
Jarmolinski 2020 [34] | Case report | 1 | 1 | 9.00 | 0 | ALL | Allo | 7 |
Flores 2020 [35] | Letter to the editor | 3 | 1 | 8.00 | 0 | ALL | Allo | NA |
Innes 2020 [36] | Case report | 1 | 1 | 53.00 | 1 | CML | Allo | 3 years |
Pinana 2020 [37] | Original article | 367 | 123 | 54.10 | 74 | AML (23), ALL (13), MDS (10), CMPD (2), NHL (23), CLL (2), plasma cell leukemia (41), aplastic anemia or autoimmune disease (6) | Auto, 58; allo, 65 | Auto, 790 (10–10,661); allo, 441 (6–7597) |
Karatas 2020 [38] | Case report | 1 | 1 | 61.00 | 1 | HL, peripheral T-cell lymphoma | Auto | 125 days |
Dhakal 2020 [39] | Correspondence | 7 | 2 | 67.60 | 1 | MM | Auto (2) | NA |
Angelini 2020 [40] | Case report | 1 | 1 | 60.00 | 1 | MM | Auto | 26 months |
Nawar 2020 [41] | Correspondence | 3 | 1 | 35.00 | 0 | Mediastinal DLBCL | Auto | 2 months |
Shah 2020 [16] | Original article | 77 | 72 | 62.00 | 46 | MM (28), NHL (15), leukemia-all types (19), MDS (4), HL (4), amyloidosis (1), MPN (1); SCT recipients | Allo, 35; auto, 37 | Median, 782 days |
Haroon 2020 [42] | Case series | 11 | 11 | 40.50 | 7 | MM (3), B-cell ALL (3), HL (1), CML (1), AML (2), DLBCL (1) | Allo, 7; auto, 5 | Range, day 5–192 months |
de Rojas 2020 [43] | Letter to the editor | 15 | 4 | NA | NA | NA | NA | 209 days (range, 113–749 days) |
Huang 2020 [21] | Case report | 2 | 1 | 51.00 | 1 | AML | Allo | 17 months |
Garnica 2020 [44] | Original article | 101 | 2 | NA | NA | NA | Allo (2) | >day 100 |
Kanellopoulos 2020 [45] | Case series | 7 | 7 | 61.30 | 2 | NA | Auto, 1; allo, 6 | 7–343 days |
Wang 2020 [46] | Original article | 58 | 22 | NA | NA | MM | Auto, 22; allo, 0 | NA |
Fox 2020 [47] | Original article | 55 | 9 | NA | NA | NA | Auto, 7; allo, 2 | Auto, 0 to >6 months; allo, 0 to <6 months |
Al Yazidi 2020 [48] | Letter to the editor | 3 | 1 | NA | NA | Primary immunodeficiency | Allo | 23 months |
Aydillo 2020 [49] | Correspondence | 20 | 18 | NA | NA | NA | NA | NA |
Balashov 2021 [50] | Original article | 1 | 1 | 1.00 | 0 | JMML | Allo | 3 months (day 99) |
Faura 2020 [51] | Letter to the editor | 47 | 8 | NA | NA | NA | NA | NA |
Foss 2020 [52] | Commentary | 1 | 1 | 47.00 | 1 | AITL | Allo | 17 months |
Garcia-Suarez 2020 [53] | Original article | 692 | 78 | NA | NA | NA | Auto, 51; allo, 27 | 8–56 months |
Issa 2020 [54] | Letter to the editor | 1 | 1 | 53.00 | 1 | MCL | Auto | ~2 years |
Jimenez-Kurlander 2021 [55] | Brief report | 321 | 7 | NA | NA | NA | NA | NA |
Krengli 2020 [56] | Case report | 1 | 1 | 62.00 | 0 | MM | Auto | 6 months |
Lazaro Del Campo 2021 [57] | Expert review | 17 | 1 | 22.00 | 10 | AML | Allo | NA |
Niu 2020 [58] | Correspondence | 2 | 2 | 60.00 | 1 | B-cell ALL, AML | Allo | 5–10 months |
Rouger-Gaudichon 2020 [59] | Original article | 37 | 4 | NA | NA | NA | NA | NA |
Sanchez-Pina 2020 [60] | Original article | 92 | 4 | NA | NA | NA | Auto, 3; allo, 1 | <6 months |
(A) | |||||
Outcome | No. of Studies | No. of Patients | Effect | 95% CI | Heterogeneity: I2, p-Value |
COVID-19–related death | 29 | 368 | 21.08% | 17.18–25.60% | 0%, 0.9841 |
Time from SCT | |||||
0–100 days | 3 | 74 | 38.64% | 3.26–92.18% | 77.3%, 0.0122 |
100 days–6 months | 4 | 77 | 34.19% | 6.20–80.34% | 69.9%, 0.0189 |
<6 months | 7 | 151 | 29.98% | 10.48–61.03% | 68.1%, 0.0044 |
>6 months | 13 | 88 | 85.32% | 75.54–91.62% | 0%, 0.8550 |
GvHD | 8 | 20 | 59.36% | 34.21–80.41% | 11.6%, 0.3397 |
Acute | 5 | 16 | 40.20% | 11.80–77.16% | 36.6%, 0.1775 |
Chronic | 6 | 18 | 60.91% | 25.39–87.70% | 39.4%, 0.1427 |
Immunosuppression | 20 | 236 | 39.44% | 25.11–55.86% | 46.7%, 0.0116 |
Use of steroids | 12 | 223 | 18.46% | 6.47–42.55% | 53.2%, 0.0149 |
Use of hydroxychloroquine | 13 | 229 | 53.27% | 36.97–68.91% | 56.9%, 0.0058 |
Use of antibiotics | 12 | 100 | 37.94% | 25.89–51.68% | 9.8%, 0.3494 |
Use of antivirals | 7 | 136 | 71.61% | 24.11–95.24% | 74.5%, 0.0006 |
Symptoms | |||||
Fever | 8 | 201 | 70.89% | 64.22–76.78% | 0%, 0.6860 |
Respiratory | 11 | 205 | 76.14% | 57.13–88.36% | 53.9%, 0.0168 |
Gastrointestinal | 3 | 197 | 19.25% | 12.47–28.52% | 0%, 0.4789 |
Hospital admission | 24 | 273 | 55.20% | 47.37–62.78% | 94.8%, <0.0001 |
(B) | |||||
Outcome | No. of Studies | No. of Patients | Effect | 95% CI | Heterogeneity: I2, p-Value |
COVID-related death | 15 | 100 | 21.73% | 14.7–30.91% | 0%, p = 0.9387 |
Mean time from SCT to COVID infection (month) | 13 | 98 | 9.99 | 7.79–12.81% | 100%, p < 0.0001 |
GvHD | 11 | 24 | 57.56% | 38.62–74.52% | 0%, p = 0.8550 |
Acute | 8 | 16 | 42.03% | 22.21–64.80% | 0%, p = 0.7675 |
Chronic | 8 | 16 | 53.95% | 26.86–78.89% | 10.1%, p = 0.3519 |
Immunosuppression | 14 | 88 | 51.27% | 40.93–61.50% | 0%, p = 0.6718 |
Use of steroids | 11 | 89 | 26.16% | 11.92–48.12% | 23.6%, p = 0.2188 |
Use of HQ | 7 | 89 | 45.02% | 34.83–55.65% | 0%, p = 0.4385 |
Use of antibiotics | 8 | 21 | 47.75% | 28.32–67.88% | 0%; p = 0.7058 |
Use of antiviral | 5 | 76 | 40.71% | 30.10–52.25% | 0%, p = 0.4058 |
Symptoms | |||||
Fever | 5 | 69 | 64.25% | 52.64–74.40% | 0%, p = 0.9797 |
Respiratory | 6 | 70 | 80.58% | 70.04–88.05% | 0%, p = 0.9987 |
Hospital admission | 12 | 90 | 67.18% | 57.24–75.79% | 0%, p = 0.9999 |
(A) Meta-regression analysis of COVID-19–related mortality in all SCT patients. | ||
Variable | β (± SE) | p-value |
Time from SCT | ||
0–100 days | 0.0035 ± 0.0128 | 0.7866 |
100 days-6 months | 0.0026 ± 0.0126 | 0.8360 |
<6 months | 0.0035 ± 0.0101 | 0.7276 |
>6 months | 0.0574 ± 0.0465 | 0.2169 |
GvHD | 0.0283 ± 0.0197 | 0.1507 |
Acute | 0.0031 ± 0.0144 | 0.8306 |
Chronic | 0.0272 ± 0.0187 | 0.1450 |
Immunosuppression | 0.0074 ± 0.0063 | 0.2434 |
Use of steroids | 0.0033 ± 0.0103 | 0.7482 |
Use of hydroxychloroquine | 0.0003 ± 0.0077 | 0.9698 |
Use of antibiotics | 0.0116 ± 0.0084 | 0.1682 |
Use of antivirals | 0.0045 ± 0.0101 | 0.6568 |
Hospital admission | 0.0005 ± 0.0058 | 0.9376 |
(B) Meta-regression analysis of COVID-19–related mortality in allogenic SCT patients. | ||
Variable | β ± SE | p-value |
GvHD total | 0.0097 ± 0.0136 | 0.4738 |
Acute GvHD | −0.0043 ± 0.0142 | 0.7628 |
Chronic GvHD | 0.0106 ± 0.0127 | 0.4057 |
Immunosuppression | 0.0109 ± 0.0100 | 0.2759 |
Use of steroids | 0.0023 ± 0.0107 | 0.8301 |
Use of HQ | −0.0024 ± 0.0172 | 0.8878 |
Use of antibiotics | 0.0189 ± 0.0135 | 0.1602 |
Use of antiviral | 0.0178 ± 0.0159 | 0.2627 |
Hospital admission | 0.0245 ± 0.0193 | 0.2049 |
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Kamal, M.; Baudo, M.; Joseph, J.; Geng, Y.; Mohamed, O.; Rahouma, M.; Greenbaum, U. Characteristics and Outcomes of Stem Cell Transplant Patients during the COVID-19 Era: A Systematic Review and Meta-Analysis. Healthcare 2024, 12, 530. https://doi.org/10.3390/healthcare12050530
Kamal M, Baudo M, Joseph J, Geng Y, Mohamed O, Rahouma M, Greenbaum U. Characteristics and Outcomes of Stem Cell Transplant Patients during the COVID-19 Era: A Systematic Review and Meta-Analysis. Healthcare. 2024; 12(5):530. https://doi.org/10.3390/healthcare12050530
Chicago/Turabian StyleKamal, Mona, Massimo Baudo, Jacinth Joseph, Yimin Geng, Omnia Mohamed, Mohamed Rahouma, and Uri Greenbaum. 2024. "Characteristics and Outcomes of Stem Cell Transplant Patients during the COVID-19 Era: A Systematic Review and Meta-Analysis" Healthcare 12, no. 5: 530. https://doi.org/10.3390/healthcare12050530