Open AccessCOVID‐19 outcomes in haematopoietic cell transplant recipients: A systematic review and meta‐analysis
Author(s) -
Lim Yeong Jer,
Khan Umair,
Karpha Indrani,
Ross Andrew,
Saif Muhammad,
Remberger Mats,
Kalakonda Nagesh,
Pettitt Andrew R.,
Floisand Yngvar
Publication year - 2022
Publication title -
ejhaem
Language(s) - English
Resource type - Journals
ISSN - 2688-6146
DOI - 10.1002/jha2.465
Subject(s) - medicine , context (archaeology) , meta analysis , confidence interval , pandemic , covid-19 , relative risk , intensive care unit , transplantation , mechanical ventilation , adverse effect , intensive care medicine , disease , infectious disease (medical specialty) , paleontology , biology
Up‐to‐date information on coronavirus disease 2019 (COVID‐19) outcomes and risk factors in haematopoietic cell transplantation (HCT) recipients is required to inform on decisions about cancer treatment and COVID‐19 mitigation strategies. We performed a meta‐analysis to address this knowledge gap. All studies with at least five patients who reported COVID‐19‐related deaths in HCT recipients were included. The primary outcome was COVID‐19‐related death. Secondary outcomes were COVID‐19‐related mechanical ventilation (MV) and intensive care unit (ITU) admission. The cumulative COVID‐19‐related death rate among HCT recipients was 21% (95% confidence interval [CI] 18%–24%), while MV and ITU admission rates were 14% (95% CI 11%–17%) and 18% (95% CI 14%–22%), respectively. Subgroup analysis showed higher death rates in patients who developed COVID‐19 within 12 months of HCT (risk ratio [RR] 1.82, 95% CI 1.09–3.03), within 6 months of receiving immunosuppressant drugs (RR 2.11, 95% CI 1.38–3.20) or in the context of active graft‐versus‐host disease (RR 2.38, 95% CI 1.10–5.16). Our findings support the idea that HCT should remain an integral part of cancer treatment during the COVID‐19 pandemic but also highlight the need to prioritise preventative measures in those patients who are at increased risk of adverse COVID‐19 outcomes.