Burden of Seasonal Human Coronavirus Infections in Hematopoietic Cell Transplant Recipients

Community respiratory viruses, such as seasonal human coronavirus (HCoV), commonly infect hematopoietic cell transplant (HCT) recipients. Recognizing the risk factors and outcomes of HCoV infections in HCT recipients is essential for the future development of potentially lifesaving therapeutics.

We performed a retrospective review of all HCoV-infected HCT recipients from September 1, 2015 to August 31, 2017, at our institution. Patients were classified with upper respiratory tract infection (URI) or lower respiratory infection (LRI) based on predefined definitions for respiratory viral infections in HCT recipients. Patient data were collected to identify risk factors for HCoV LRI, and to calculate an immunodeficiency scoring index (ISI). Univariate and multivariate analysis were performed to identify risk factors for LRI.

We identified 164 episodes in 138 HCT recipients (129 URI and 35 LRI) during the study period with an incidence of HCoV of 9%. Overall, 30-day mortality was 17% and 0%, among patients with HCoV LRI or URI, respectively. On multivariate analysis, low-albumin, coinfection with multiple respiratory viruses, and an ISI ≥ 5 were independent predictors of LRI and the latter was associated with increased risk of hospital admission, ICU admission, mechanical ventilation, and 30-day mortality.

We identified unique characteristics that were associated with HCoV LRI in HCT recipients. An ISI ≥ 5 predicted HCoV LRI in HCT recipients.