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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Pediatric Hematology and Hematological Malignancies
Volume 12 - 2024 | doi: 10.3389/fped.2024.1489648

The impact of SARS-CoV-2 infection on immunity reconstitution among pediatric patients after allogeneic hematopoietic stem cell transplantation: a propensity score-matched analysis

Provisionally accepted
Xin Wang Xin Wang *Lipeng Liu Lipeng Liu *Luyang Zhang Luyang Zhang *Yue Shang Yue Shang *Xia Chen Xia Chen *Yuanyuan Ren Yuanyuan Ren *Fang Liu Fang Liu *Wenbin An Wenbin An *Yang Wan Yang Wan *Xiaolan Li Xiaolan Li *Wenyu Yang Wenyu Yang Xiaofan Zhu Xiaofan Zhu *Ye Guo Ye Guo *
  • Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China

The final, formatted version of the article will be published soon.

    Background: Immunity reconstitution (IR) is crucial for pediatric patients undergoing hematopoietic stem cell transplantation (HSCT), but the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on lymphocyte subsets post-transplant remains unclear. Therefore, we assessed immune cell dynamics in children after SARS-CoV-2 infection. Methods: We enrolled 42 children, including 21 post-HSCT SARS-CoV-2 infected and 21 matched, non-infected historical controls (1:1 matching based on propensity scores). The time from HSCT to SARS-CoV-2 infection in the infected group was determined by the beginning of follow-up for the non-infected group. The primary endpoint was 270-day IR kinetics post-infection.Results: Our findings showed similar recovery trends between the infected group and non-infected group both in UCB and HID recipients. In the UCB cohort, the NK cell reconstitution in the infected group was poorer compared to the non-infected group, but this difference did not reach statistical significance (P=0.178). Furthermore, HID transplantation might be a trend towards poor CD19+ T-cell reconstitution (hazard ratio [HR]: 0.43, 95% CI: 0.18-1.04, p = 0.06). No statistically significant difference was observed in terms of secondary infections across the UCB (P=0.150) and HID (P=0.980) cohorts as well as there was no discernible difference in overall survival between the two groups (P=1).Conclusions: Our analysis reveals that SARS-CoV-2 might temporarily impaired the IR process in the short term, with recovery to a comparable trend as observed in non-infected patients approximately 9 months post-infection.

    Keywords: COVID-19, Hematopoietic Stem Cell Transplantation, Immune reconstitution, Pediatrics, Virus Diseases

    Received: 01 Sep 2024; Accepted: 05 Nov 2024.

    Copyright: © 2024 Wang, Liu, Zhang, Shang, Chen, Ren, Liu, An, Wan, Li, Yang, Zhu and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Xin Wang, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
    Lipeng Liu, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
    Luyang Zhang, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
    Yue Shang, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
    Xia Chen, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
    Yuanyuan Ren, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
    Fang Liu, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
    Wenbin An, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
    Yang Wan, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
    Xiaolan Li, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
    Xiaofan Zhu, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
    Ye Guo, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China

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