Incidence, significance, and persistence of human coronavirus infection in hematopoietic stem cell transplant recipients.

Journal Article (Clinical Trial;Journal Article)

Hematopoietic stem cell transplant (HSCT) recipients are at increased risk of respiratory viral infections and their associated complications. Unlike other respiratory viruses, little is known about the clinical significance of human coronavirus infection (HCoV) in this population. We retrospectively identified all HSCT recipients who were transplanted between May 2013 and June 2017 at our institution and characterized the cumulative incidence of post-transplant HCoV infection. Of 678 patients who underwent HSCT during the study period, 112 (17%) developed HCoV infection, making HCoV the fourth most common respiratory viral infection. Thirty-four (30%) HCoV-infected patients progressed to proven or probable lower respiratory tract infection (LRTI). Age ≥50, graft-versus-host disease, corticosteroids, hypoalbuminemia, and inpatient status at the time of infection were independently associated with progression to LRTI. Twenty-seven (59%) patients who underwent repeat NP swab had persistent viral shedding for ≥21 days, with a median duration of 4 weeks of viral shedding. We conclude that HCoV is common and clinically significant in HSCT recipients, with nearly one-third of patients progressing to proven or probable LRTI. Evaluating for LRTI risk factors found in this study may identify patients who require closer surveillance and aggressive supportive care when infected with HCoV.

Full Text

Duke Authors

Cited Authors

  • Eichenberger, EM; Soave, R; Zappetti, D; Small, CB; Shore, T; van Besien, K; Douglass, C; Westblade, LF; Satlin, MJ

Published Date

  • July 2019

Published In

Volume / Issue

  • 54 / 7

Start / End Page

  • 1058 - 1066

PubMed ID

  • 30385869

Pubmed Central ID

  • 30385869

Electronic International Standard Serial Number (EISSN)

  • 1476-5365

International Standard Serial Number (ISSN)

  • 0268-3369

Digital Object Identifier (DOI)

  • 10.1038/s41409-018-0386-z

Language

  • eng