Ursodeoxycholic acid does not reduce SARS-CoV-2 infection in newly allogeneic hematopoietic stem cell transplantation recipients: a prospective NICHE cohort

Frontiers in Cellular and Infection Microbiology, Journal Year: 2024, Volume and Issue: 14

Published: March 5, 2024

Introduction Retrospective studies have suggested that Ursodeoxycholic Acid (UDCA) provide a protective effect against SARS-CoV-2 infection, particularly in patients with liver disease. However, it is uncertain whether this finding can be extended to the allogeneic hematopoietic stem cell transplantation (allo-HSCT) cohort. Therefore, we aim examine potential of UDCA infection recently received allo-HSCT patients. Methods During initial Omicron variant wave China (December 2022 February 2023), conducted prospective observational study involving 91 hospitalized who had undergone within previous 6 months as part National Longitudinal Cohort Hematological Diseases (NICHE). Throughout hospitalization, continuously monitored status COVID-19 using PCR kits or Antigen Rapid Tests. Results Among these patients, 67.0% (n = 61) were confirmed contracted infection. For 52 evaluated, 23.1% experienced severe critical clinical course. There was no difference rate severity between group and non-UDCA group. We found only transplanted 3 ago demonstrated higher risk compared those (Odds Ratio [OR]: 3.241, 95% Confidence Interval [CI]: 1.287-8.814, P 0.016). But other factors, such administration UDCA, showed difference. Notably, age ≥38 years old remained an independent factor for course (OR: 3.664, CI: 1.129-13.007, 0.035). Conclusion The effectiveness protecting newly recipients remains unconfirmed. Presently, most effective strategy appears minimizing exposure SARS-CoV-2. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT04645199 , identifier NCT04645199.

Language: Английский

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Stimulation of Potent Humoral and Cellular Immunity via Synthetic Dual-Antigen MVA-Based COVID-19 Vaccine COH04S1 in Cancer Patients Post Hematopoietic Cell Transplantation and Cellular Therapy

Vaccines, Journal Year: 2023, Volume and Issue: 11(9), P. 1492 - 1492

Published: Sept. 15, 2023

Hematopoietic cell transplantation (HCT) and chimeric antigen receptor (CAR)-T patients are immunocompromised, remain at high risk following SARS-CoV-2 infection, less likely than immunocompetent individuals to respond vaccination. As part of the safety lead-in portion a phase 2 clinical trial in post HCT/CAR-T for hematological malignancies (HM), we tested immunogenicity synthetic modified vaccinia Ankara-based COVID-19 vaccine COH04S1 co-expressing spike (S) nucleocapsid (N) antigens. Thirteen were vaccinated 3-12 months with two four doses COH04S1. antigen-specific humoral cellular immune responses, including neutralizing antibodies ancestral virus variants concern (VOC), measured up six vaccination compared responses historical cohorts naïve healthy volunteers (HV) healthcare workers (HCW) FDA-approved mRNA Comirnaty® (Pfizer, New York, NY, USA). After one or doses, recipients showed significant increase S- N-specific binding antibody titers potent activity against VOC, highly evasive Omicron XBB.1.5 variant. Furthermore, resulted T cells, predominantly CD4+ lymphocytes. Elevated continued persist both COH04S1-vaccinated superior comparable those HV Comirnaty®-vaccinated HCW. These results demonstrate robust stimulation cross-reactive by HM HCT/CAR-T, supporting further testing immunocompromised populations.

Language: Английский

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Characteristics and Outcomes of Stem Cell Transplant Patients during the COVID-19 Era: A Systematic Review and Meta-Analysis

Healthcare, Journal Year: 2024, Volume and Issue: 12(5), P. 530 - 530

Published: Feb. 23, 2024

This systematic review and meta-analysis aims to identify the outcomes of stem cell transplant (SCT) patients during COVID-19 era. Pooled event rates (PER) were calculated, meta-regression was performed. A random effects model utilized. In total, 36 eligible studies included out 290. The PER COVID-19-related deaths hospital admissions 21.1% 55.2%, respectively. use hydroxychloroquine 53.27%, receipt immunosuppression it 39.4%, antivirals, antibiotics, steroids 71.61%, 37.94%, 18.46%, time elapsed until infection after SCT more than 6 months 85.3%. fever, respiratory symptoms, gastrointestinal symptoms 70.9, 76.1, 19.3%, acute chronic GvHD 40.2% 60.9%, are at a higher risk severe mortality. dexamethasone improves survival hospitalized with moderate requiring supplemental oxygen or ventilation. patient group is heterogeneous varying characteristics. quality reporting on these when infected not uniform further prospective registry needed better guide clinical care in this unique setting.

Language: Английский

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COVID-19 antibody titers after tixagevimab–cilgavimab injection in patients with hematologic diseases; a single-center, prospective study

Leukemia & lymphoma/Leukemia and lymphoma, Journal Year: 2024, Volume and Issue: 65(8), P. 1117 - 1126

Published: April 16, 2024

Knowledge of the SARS-CoV-2 antibody titers induced by tixagevimab–cilgavimab in patients with hematologic diseases remains insufficient. Here, we performed a single-center, prospective study to reveal changes titer after administration 78 diseases. The median peak was 155.4 U/mL, and AUC 46556 days·U/mL. First, compared several characteristics between low (peak ≤ U/mL) high > U/mL). We extracted 6 factors (patient age, sex, ECOG-PS, serum albumin level, cross-sectional area computed tomographic number psoas major muscle) as candidates influencing titers. Multiple regression analysis revealed that closely associated these (contribution rate = 0.76, p 0.02). Our data support inability induce sufficient against SARS-CoV-2, especially older, frailer, female patients.

Language: Английский

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Raising awareness may increase the likelihood of hematopoietic stem cell donation: analysis of a nationwide survey using Artificial Intelligence

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: April 26, 2024

Background: In Italy, the demand for allogeneic transplantation exceeds number of compatible donors registered in Italian Bone Marrow Donor Registry (IBMDR). As various factors likely contribute to donor shortage, our aim was explore knowledge, beliefs, opinions, values, and feelings population regarding stem cell donation. Methods: An online survey shared through social media. Two groups respondents were retrospectively identified as those who (currently or previously) on IBMDR (Donor Group) had never (Non-Donor Group). Statistical analyses performed confirm relationship between respondents’ knowledge level their willingness donate. Then, a generative artificial intelligence strategy applied using questionnaire responses features train 6 different classifiers machine learning process. The predict probability enrollment. Results: A total 1518 from throughout Italy participated study. Among NDG, lower donation needs (51.7% vs 24.4%, p<0.001) negative such fear (Z=-2.2642, p=0.02), perplexity (Z=4.4821, p<0.001), uncertainty (Z=3.3425, emerged. higher about associated processes predicted greater likelihood analysis showed an area under ROC curve (AUC) ranging 0.65 0.81, depending classifier. Conclusions: results underscore need improve strategies raise awareness its process among population.

Language: Английский

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Impact of prior COVID‐19 infection on allogeneic hematopoietic stem cell transplantation outcomes

Clinical Transplantation, Journal Year: 2024, Volume and Issue: 38(5)

Published: May 1, 2024

Abstract There are limited data on outcomes of allogeneic hematopoietic stem cell transplantation (allo‐HSCT) in recipients with prior COVID‐19 infection. This single‐center retrospective study included 54 adult patients who received allo‐HSCT from July 2020 to September 2021 after previous infection and 122 control group without a history underwent HSCT during the same period, median follow‐up 17 months. Median time was 211 days. The incidence main complications post‐transplant period not significantly different between two groups: deep vein thrombosis ( p = .85), TMA .8), VOD .25), bloodstream infections .21), pneumonia any etiology .41), viral invasive fungal disease .08). 2‐year non‐relapse mortality, relapse incidence, overall survival, progression‐free survival also were comparable 22% (95% CI 10.5–36.2) versus 26.3% 18.7–34.6) .4; 15.6% 7.3–26.9) 23.6% 16.0–32.3) .39; 67.9% 50.4–80.3) 59.8% 50.2–68.1) .24 62.3% 45.5–75.3) 49.9% 40.0–59.1) .18, respectively. did affect results allo‐HSCT.

Language: Английский

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Outcomes of hematopoietic stem cell transplantation in patients with SARS-CoV-2 infection during the Omicron era

International Journal of Infectious Diseases, Journal Year: 2024, Volume and Issue: 147, P. 107207 - 107207

Published: Aug. 14, 2024

Language: Английский

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Immunogenicity of Comirnaty Omicron XBB.1.5 booster COVID-19 mRNA vaccine in long-term survivors after allogeneic hematopoietic stem cell transplantation

Scientific Reports, Journal Year: 2024, Volume and Issue: 14(1)

Published: Oct. 21, 2024

Abstract Primary mRNA vaccination against COVID-19 typically involves three doses for immunocompromised individuals, including hematopoietic stem cell transplantation (allo-HSCT) recipients. However, optimal subsequent boosting strategies remain unclear. This study aimed to assess the immunogenicity of a booster dose using most recently updated vaccine (Comirnaty Omicron XBB.1.5) among long-term allo-HSCT survivors having previously received multiple doses, in median 4 (2–6). Thirty-four recipients were enrolled at Sahlgrenska University Hospital, and peripheral blood samples collected immediately before four weeks after booster. Antibodies receptor-binding domain (anti-RBD) spike 1 (S1) nucleocapsid, as well S1-specific ex vivo T-cell responses, evaluated. Adverse events monitored. Despite 13 months since prior dose, both humoral responses S1 present pre-booster all but two participants, who suffered from severe chronic Graft-versus-host disease. Notably, 62% participants had confirmed infection. Significantly higher antibody levels observed women than men ( p = 0.003). Booster dosing strengthened specific T equalized gender differences, although remained significantly lower those receiving immunosuppressive treatment 0.041). In population survivors, majority whom infection, pre- post-booster immune robust. patients undergoing GvHD exhibited weaker responses.

Language: Английский

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Prevention is better than cure: immunocompromised people need COVID-19 prevention therapies now

Infectious Diseases, Journal Year: 2024, Volume and Issue: 56(12), P. 1107 - 1110

Published: Oct. 31, 2024

Immunocompromised people are facing ongoing inequality in health outcomes because of COVID-19. Let's remain ambitious and improve availability access to COVID-19 prevention therapies that protect patients aid management. This article brings together opinions from four experts based the United Kingdom who specialise immunology, solid organ transplantation, respiratory medicine critical care, oncology haematology. In this article, they communicate impact SARS-CoV-2 infection on vulnerable with underlying conditions need for immediate policies

Language: Английский

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