AUTHOR=Ljungman Per , Tridello Gloria , Piñana Jose Luis , Ciceri Fabio , Sengeloev Henrik , Kulagin Alexander , Mielke Stephan , Yegin Zeynep Arzu , Collin Matthew , Einardottir Sigrun , Lepretre Sophie Ducastelle , Maertens Johan , Campos Antonio , Metafuni Elisabetta , Pichler Herbert , Folber Frantisek , Solano Carlos , Nicholson Emma , Yüksel Meltem Kurt , Carlson Kristina , Aguado Beatriz , Besley Caroline , Byrne Jenny , Heras Immaculada , Dignan Fiona , Kröger Nicolaus , Robin Christine , Khan Anjum , Lenhoff Stig , Grassi Anna , Dobsinska Veronika , Miranda Nuno , Jimenez Maria-Jose , Yonal-Hindilerden Ipek , Wilson Keith , Averbuch Dina , Cesaro Simone , Xhaard Alienor , Knelange Nina , Styczynski Jan , Mikulska Malgorzata , de la Camara Rafael 

TITLE=Improved outcomes over time and higher mortality in CMV seropositive allogeneic stem cell transplantation patients with COVID-19; An infectious disease working party study from the European Society for Blood and Marrow Transplantation registry

JOURNAL=Frontiers in Immunology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1125824

DOI=10.3389/fimmu.2023.1125824

ISSN=1664-3224

ABSTRACT=<sec><title>Introduction</title><p>COVID-19 has been associated with high morbidity and mortality in allogeneic hematopoietic stem cell transplant (allo-HCT) recipients.</p></sec><sec><title>Methods</title><p>This study reports on 986 patients reported to the EBMT registry during the first 29 months of the pandemic.</p></sec><sec><title>Results</title><p>The median age was 50.3 years (min – max; 1.0 – 80.7). The median time from most recent HCT to diagnosis of COVID-19 was 20 months (min – max; 0.0 – 383.9). The median time was 19.3 (0.0 - 287.6) months during 2020, 21.2 (0.1 - 324.5) months during 2021, and 19.7 (0.1 – 383.9) months during 2022 (p = NS). 145/986 (14.7%) patients died; 124 (12.6%) due to COVID-19 and 21 of other causes. Only 2/204 (1%) fully vaccinated patients died from COVID-19. There was a successive improvement in overall survival over time. In multivariate analysis, increasing age (p&lt;.0001), worse performance status (p&lt;.0001), contracting COVID-19 within the first 30 days (p&lt;.0001) or 30 – 100 days after HCT (p=.003), ongoing immunosuppression (p=.004), pre-existing lung disease (p=.003), and recipient CMV seropositivity (p=.004) had negative impact on overall survival while patients contracting COVID-19 in 2020 (p&lt;.0001) or 2021 (p=.027) had worse overall survival than patients with COVID-19 diagnosed in 2022.</p></sec><sec><title>Discussion</title><p>Although the outcome of COVID-19 has improved, patients having risk factors were still at risk for severe COVID-19 including death.</p></sec>