TY - JOUR
T1 - Prior COVID-19 infection may increase risk for developing endothelial dysfunction following hematopoietic cell transplantation
AU - Ariagno, Sydney
AU - Ragoonanan, Dristhi
AU - Khazal, Sajad
AU - Mahadeo, Kris M.
AU - Cisneros, Gabriel Salinas
AU - Zinter, Matt S.
AU - Blacken, Robyn A.
AU - Mohan, Gopi
AU - Lehmann, Leslie E.
AU - Ferdjallah, Asmaa
AU - Mara, Kristin C.
AU - Kohorst, Mira A.
N1 - Publisher Copyright:
Copyright © 2023 Ariagno, Ragoonanan, Khazal, Mahadeo, Cisneros, Zinter, Blacken, Mohan, Lehmann, Ferdjallah, Mara and Kohorst.
PY - 2023/1/17
Y1 - 2023/1/17
N2 - Endothelial dysfunction underlies many of the major complications following hematopoietic cell transplantation (HCT), including transplant-associated thrombotic microangiopathy (TA-TMA), veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS), and engraftment syndrome (ES). Emerging evidence similarly implicates endothelitis and microangiopathy in severe COVID-19-related multi-system organ dysfunction. Given the overlap in these two illness states, we hypothesize that prior COVID-19 infection may increase risk for HCT-related endotheliopathies. This retrospective, multicenter study included patients aged 0-25 years who underwent autologous or allogeneic HCT for any indication between January 1, 2020 and September 21, 2021, with close attention to those infected with COVID-19 in either the six months prior to transplant or twelve months following transplant. Incidences of TA-TMA, VOD/SOS, and ES were compared among patients with COVID-19 infection pre-HCT and post-HCT, as well as with historical controls who were never infected with SARS-CoV-2. Those who underwent HCT following COVID-19 infection displayed significantly increased rates of TA-TMA compared to those who were never infected. Additionally, our data suggests a similar trend for increased VOD/SOS and ES rates, although this did not reach statistical significance. Therefore, a history of COVID-19 infection prior to undergoing HCT may be a nonmodifiable risk factor for endothelial-related complications following HCT. Further studies are warranted to better clarify this relationship among larger cohorts and in the era of the Omicron SARS-CoV-2 variants.
AB - Endothelial dysfunction underlies many of the major complications following hematopoietic cell transplantation (HCT), including transplant-associated thrombotic microangiopathy (TA-TMA), veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS), and engraftment syndrome (ES). Emerging evidence similarly implicates endothelitis and microangiopathy in severe COVID-19-related multi-system organ dysfunction. Given the overlap in these two illness states, we hypothesize that prior COVID-19 infection may increase risk for HCT-related endotheliopathies. This retrospective, multicenter study included patients aged 0-25 years who underwent autologous or allogeneic HCT for any indication between January 1, 2020 and September 21, 2021, with close attention to those infected with COVID-19 in either the six months prior to transplant or twelve months following transplant. Incidences of TA-TMA, VOD/SOS, and ES were compared among patients with COVID-19 infection pre-HCT and post-HCT, as well as with historical controls who were never infected with SARS-CoV-2. Those who underwent HCT following COVID-19 infection displayed significantly increased rates of TA-TMA compared to those who were never infected. Additionally, our data suggests a similar trend for increased VOD/SOS and ES rates, although this did not reach statistical significance. Therefore, a history of COVID-19 infection prior to undergoing HCT may be a nonmodifiable risk factor for endothelial-related complications following HCT. Further studies are warranted to better clarify this relationship among larger cohorts and in the era of the Omicron SARS-CoV-2 variants.
KW - COVID-19
KW - endothelial dysfunction
KW - engraftment syndrome
KW - hematopoietic cell transplant
KW - TA-TMA
KW - VOD/SOS
UR - http://www.scopus.com/inward/record.url?scp=85147178925&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85147178925&partnerID=8YFLogxK
U2 - 10.3389/fonc.2022.1000215
DO - 10.3389/fonc.2022.1000215
M3 - Article
C2 - 36733348
AN - SCOPUS:85147178925
SN - 2234-943X
VL - 12
JO - Frontiers in Oncology
JF - Frontiers in Oncology
M1 - 1000215
ER -