PDF(Pubmed)
Abstract：
BACKGROUND: In December 2022, a large-scale epidemic occurred in China due to Omicron variant of SARS-CoV-2. This study explored risk factors for Omicron infection in transplant recipients at our institution and investigated the factors influencing the severity of SARS-CoV-2 Omicron infection among recipients of allo-HSCT.
METHODS: This single-center study investigated totally 63 allogeneic hematopoietic stem cell transplant patients infected with Omicron variant at the Beijing GoBroad Boren Hospital Transplant Center during December 2022 and analyzed their risk factors.
RESULTS: The study included 63 allogeneic hematopoietic stem cell transplant patients who developed Omicron infection. There were 34 mild and 29 moderate to severe cases. Their median age was 22 years (range, 1-65 years), with the male-to-female ratio being 1:1.1. Acute myeloid leukemia (53.97%), acute lymphoblastic leukemia (42.86%), and non-Hodgkin lymphoma (3.17%) were underlying diseases. The median time between HCT and Omicron infection was 8.45 months. Significant predictive factors for moderate to severe Omicron infection included older age (p < .0001), cGVHD (p = .0195), concurrent bacterial infection (p < .0001), low absolute lymphocyte count (p = .026), low CD4/CD8 ratio (p = .0091), high CRP (p < .0001), high serum ferritin (p = .0023), high D-dimer (p < .0001), low CD4 absolute count (p = .0057), and low B-cell absolute count (p = .0154). A moderate to high HCT-CI score tended to be associated with moderate to severe infection (p = .0596).
CONCLUSIONS: This study indicates that risk factors for severe Omicron infection include certain clinical characteristics, such as age, cGVHD, and inflammatory response.
METHODS: This single-center study investigated totally 63 allogeneic hematopoietic stem cell transplant patients infected with Omicron variant at the Beijing GoBroad Boren Hospital Transplant Center during December 2022 and analyzed their risk factors.
RESULTS: The study included 63 allogeneic hematopoietic stem cell transplant patients who developed Omicron infection. There were 34 mild and 29 moderate to severe cases. Their median age was 22 years (range, 1-65 years), with the male-to-female ratio being 1:1.1. Acute myeloid leukemia (53.97%), acute lymphoblastic leukemia (42.86%), and non-Hodgkin lymphoma (3.17%) were underlying diseases. The median time between HCT and Omicron infection was 8.45 months. Significant predictive factors for moderate to severe Omicron infection included older age (p < .0001), cGVHD (p = .0195), concurrent bacterial infection (p < .0001), low absolute lymphocyte count (p = .026), low CD4/CD8 ratio (p = .0091), high CRP (p < .0001), high serum ferritin (p = .0023), high D-dimer (p < .0001), low CD4 absolute count (p = .0057), and low B-cell absolute count (p = .0154). A moderate to high HCT-CI score tended to be associated with moderate to severe infection (p = .0596).
CONCLUSIONS: This study indicates that risk factors for severe Omicron infection include certain clinical characteristics, such as age, cGVHD, and inflammatory response.
摘要：
背景：2022年12月，由于SARS-CoV-2的Omicron变体，中国发生了大规模流行。本研究探讨了本机构移植受者Omicron感染的危险因素，并调查了影响allo-HSCT受者SARS-CoV-2Omicron感染严重程度的因素。
方法：这项单中心研究调查了2022年12月在北京高德博伦医院移植中心感染Omicron变异的63例异基因造血干细胞移植患者，并分析了其危险因素。
结果：该研究包括63名发生Omicron感染的异基因造血干细胞移植患者。轻度34例，中度至重度29例。他们的平均年龄为22岁(范围，1-65岁),男女比例为1:1.1。急性髓系白血病（53.97%），急性淋巴细胞白血病（42.86%），非霍奇金淋巴瘤（3.17％）是基础疾病。HCT和Omicron感染的中位时间为8.45个月。中度至重度Omicron感染的重要预测因素包括年龄较大（p<0.0001），cGVHD(p=.0195)，并发细菌感染（p<0.0001），低绝对淋巴细胞计数（p=.026），低CD4/CD8比值（p=.0091），高CRP（p<0.0001），高血清铁蛋白（p=.0023），高D-二聚体（p<0.0001），低CD4绝对计数（p=.0057），和低B细胞绝对计数(p=.0154)。中度至高度的HCT-CI评分倾向于与中度至重度感染相关(p=.0596)。
结论：这项研究表明，严重Omicron感染的危险因素包括某些临床特征，比如年龄,cGVHD,和炎症反应。
方法：这项单中心研究调查了2022年12月在北京高德博伦医院移植中心感染Omicron变异的63例异基因造血干细胞移植患者，并分析了其危险因素。
结果：该研究包括63名发生Omicron感染的异基因造血干细胞移植患者。轻度34例，中度至重度29例。他们的平均年龄为22岁(范围，1-65岁),男女比例为1:1.1。急性髓系白血病（53.97%），急性淋巴细胞白血病（42.86%），非霍奇金淋巴瘤（3.17％）是基础疾病。HCT和Omicron感染的中位时间为8.45个月。中度至重度Omicron感染的重要预测因素包括年龄较大（p<0.0001），cGVHD(p=.0195)，并发细菌感染（p<0.0001），低绝对淋巴细胞计数（p=.026），低CD4/CD8比值（p=.0091），高CRP（p<0.0001），高血清铁蛋白（p=.0023），高D-二聚体（p<0.0001），低CD4绝对计数（p=.0057），和低B细胞绝对计数(p=.0154)。中度至高度的HCT-CI评分倾向于与中度至重度感染相关(p=.0596)。
结论：这项研究表明，严重Omicron感染的危险因素包括某些临床特征，比如年龄,cGVHD,和炎症反应。
