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Clonal hematopoiesis is associated with risk of severe Covid-19

Kelly L Bolton1, Youngil Koh2,3,4, Michael B Foote5

  • 1Department of Medicine, Washington University, St Louis, MO, USA. bolton@wustl.edu.

Nature Communications
|October 14, 2021
PubMed

Insights

Clonal hematopoiesis (CH) is linked to severe COVID-19 and increased risk of bacterial infections like C. difficile. This suggests CH may predispose individuals to serious infections, warranting further study.

Area of Science:

  • Hematology
  • Immunology
  • Infectious Diseases

Background:

  • Clonal hematopoiesis (CH) involves acquired somatic mutations in hematopoietic stem cells, increasing risks for cardiovascular and malignant diseases.
  • CH is associated with altered inflammatory profiles, which can worsen outcomes in infections like COVID-19.

Purpose of the Study:

  • To investigate whether CH predisposes individuals to severe COVID-19.
  • To examine the association between CH and the risk of other infections in patients with solid tumors.

Main Methods:

  • Analysis of 525 individuals with COVID-19 from the Memorial Sloan Kettering (MSK) and Korean Clonal Hematopoiesis (KoCH) consortia.
  • Examination of infection risk in 14,211 solid tumor patients at MSK with identified CH.

Main Results:

  • CH was associated with severe COVID-19 outcomes (OR=1.85, p=0.01), particularly CH with non-cancer driver mutations (OR=2.01, p=0.01).
  • CH significantly correlated with increased risk of Clostridium difficile (HR=2.01, p=6x10^-3) and Streptococcus/Enterococcus infections (HR=1.56, p=5x10^-3) in solid tumor patients.

Conclusions:

  • CH is associated with severe COVID-19.
  • CH is linked to an elevated risk of specific bacterial infections, suggesting a broader role in infection susceptibility.

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