DİMA BARHOOM, RASHİN MOHSENİ, AMİR ALİ HAMİDİEH, MASOUD MOHAMMADPOUR, MEİSAM SHARİFZADEH, AMENE NAVAEİAN, SAHAR TAEBİ, MARYAM BEHFAR
Experimental and Clinical Transplantation - 2021;19(5):501-507
Coronavirus disease 2019 is the third zoonotic acute respiratory disease after SARS virus and Middle East respiratory syndrome. Most cases are mild in healthy children. In contrast, the infection is more severe in patients with underlying health conditions. Because there are few posttransplant reports in hematopoietic stem cell transplant patients, here we described COVID- 19 infection in 4 confirmed cases among pediatric hematopoietic stem cell transplant recipients: 3 boys and 1 girl with a median age of 6 years. Three patients presented with symptoms of lower respiratory tract disease, whereas 1 patient presented with extrapul - monary symptoms without fever or pulmonary involvement. All of the patients were on immunosup - pressive drugs, ie, 1 patient for graft-versus-host disease prophylaxis and 3 patients for graft-versus-host disease treatment. Those who were diagnosed with active graftversus- host disease required mechanical ventilation and intensive care. Two patients died from multiple organ dysfunction and resistant coinfection, and 1 patient developed pulmonary hypertension and mild cardio - megaly and remained at the hospital for more than 2 months, whereas the patient with no graft-versus-host disease was discharged and recovered. Our findings showed that COVID-19 infection among hematopoietic stem cell transplant recipients may be more severe and associated with long-term hospitalization and complica - tions. Active graft-versus-host disease, coinfections, and long-term use of immunosuppressive agents are risk factors for poor outcomes.
