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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
COVID-19 impact in Crohn’s disease patients submitted to autologous hematopoietic stem cell transplantation
Milton Artur Ruiz, Roberto Luiz Kaiser Junior, Lilian Piron-Ruiz, Tainara Souza Pinho, Lilian Castiglioni, Luiz Gustavo de Quadros
Milton Artur Ruiz, Department of Bone Marrow Transplantation, Associação Portuguesa de Beneficência, São José do Rio Preto SP 15090 470, Brazil
Roberto Luiz Kaiser Junior, Department of Surgery, Kaiser Hospital Dia, São José do Rio Preto 08010-150, São Paulo, Brazil
Lilian Piron-Ruiz, Tainara Souza Pinho, Department of Bone Marrow Transplantation, Beneficência Portuguesa Hospital, São José do Rio Preto 15090 470, São Paulo, Brazil
Lilian Castiglioni, FAMERP, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto 15090 000, São Paulo, Brazil
Luiz Gustavo de Quadros, Beneficência Portuguesa Hospital, ABC Medical School, São Bernardo 15015 110, São Paulo, Brazil
Author contributions: Ruiz MA, Piron-Ruiz L and Pinho TS wrote the paper; Castiglioni L reviewed the statistics; Kaiser Junior RL and de Quadros LG reviewed the text.
Institutional review board statement: The study was reviewed and approved by the Conselho Nacional de Saúde - Comissão Nacional de Ética em Pesquisa – CONEP.
Informed consent statement: The evaluated patients are part of studies registered in US Clinical Trials NCT 03000296 and IRD-CAAE 20 894719.1.0000.5629, infected or not by SARS-CoV-2. All consented to have their data published their identifiable data in an online, open-access journal. All patients gave their written informed consent.
Conflict-of-interest statement: None of the authors have competing interests.
Data sharing statement: All patients consented to have their data published their identifiable data in an online, open-access journal. All patients gave their written informed consent.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Milton Artur Ruiz, PhD, Doctor, Department of Bone Marrow Transplantation, Associação Portuguesa de Beneficência, Rua Catarina Nucci Parise 760, São José do Rio Preto SP 15090 470, Brazil. milruiz@yahoo.com.br
Received: October 19, 2023
Peer-review started: October 19, 2023
First decision: December 12, 2023
Revised: January 11, 2024
Accepted: March 26, 2024
Article in press: March 26, 2024
Published online: May 1, 2024
Processing time: 192 Days and 11.6 Hours
BACKGROUND
Severe acute respiratory syndrome coronavirus 2 is the virus responsible for coronavirus disease 2019 (COVID-19), a disease that has been blamed for inducing or exacerbating symptoms in patients with autoimmune diseases. Crohn's disease (CD) is an inflammatory bowel disease that affects genetically susceptible patients who develop an abnormal mucosal immune response to the intestinal microbiota. Patients who underwent hematopoietic stem cell transplantation (HSCT) are considered at risk for COVID-19.
AIM
To describe for the first time the impact of COVID-19 in CD patients who had undergone autologous, non-myeloablative HSCT.
METHODS
In this descriptive study a series of 19 patients were diagnosed with positive COVID-19. For two patients there were reports of the occurrence of two infectious episodes. Parameters related to HSCT, such as time elapsed since the procedure, vaccination status, CD status before and after infection, and clinical manifestations resulting from COVID-19, were evaluated.
RESULTS
Among the patients with COVID-19, three, who underwent Auto HSCT less than six months ago, relapsed and one, in addition to the CD symptoms, started to present thyroid impairment with positive anti-TPO. Only one of the patients required hospitalization for five days to treat COVID-19 and remained in CD clinical remission. Nine patients reported late symptoms that may be related to COVID-19. There were no deaths, and a statistical evaluation of the series of COVID-19 patients compared to those who did not present any infectious episode did not identify significant differences regarding the analyzed parameters.
CONCLUSION
Despite the change in CD status in three patients and the presence of nine patients with late symptoms, we can conclude that there was no significant adverse impact concerning COVID-19 in the evaluated patients who underwent HSCT to treat CD.
Core Tip: This report discusses the impact of coronavirus disease 2019 (COVID-19) on 50 patients with Crohn's disease (CD) who underwent autologous hematopoietic stem cell transplantation between 2013 and 2021. Of these patients, 19 were diagnosed with COVID-19, with two patients reporting two infectious episodes each and in three there was a change in the CD status. One patient required hospitalization, but there were no deaths. Overall, the study found no significant adverse impact of COVID-19 on these patients.
