Outcome of COVID 19 Infection in Bone Marrow Transplant Recipients-A Single Centre Experience

ABSTRACT

Introduction: Bone marrow transplant recipients (BMTRs) are at ahigher risk for severe disease and death following COVID-19. Herewe detail the experience from a tertiary care centre in southern India.Aims &Objectives: To assess mortality rates and outcomes inBMTRs who contracted COVID 19 infection.Materials &Methods: Case files of BMTRs who contracted COVID19 infection from June 2020 to June 2021 were reviewed to assess foroutcomes and mortality rates.Result: 12 BMTRs had contracted COVID 19 in the study period,including 10 allogenic transplant recipients and 2 autologous recipients. 2 patients had relapsed disease at the time of COVID 19infection. Out of the 12 patients, 6 (50%) had mild, 3 (25%) hadmoderate and 3 (25%) had severe disease. 10 patients were onimmunosuppression at the time of COVID 19 with steroids being themost common (n = 7) followed by MMF (n = 5) and cyclosporine(n = 3). 3 (25%) patients required ventilatory support out of whichonly one survived. The overall 30-day mortality rate was 25%(n = 3). One patient expired later due to unrelated cause (PTLD). 6(50%) patients had developed secondary infection after COVID 19.The median D dimer and CRP values were 209 ng/ml and 30.9 mg/Lrespectively. The median ferritin values for mild and severe diseasewere 1457 ng/ml and 3260 ng/ml respectively.Conclusions: COVID 19 infection in post-transplant setting is ahighly fatal disease with overall mortality of 25% comparable toavailable western studies. There is also increased incidence of secondary infections with 50% of them developing various infectionspost COVID 19.