Seasonal Human Coronavirus Respiratory Tract Infection in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation

Jose Luis Piñana, Aliénor Xhaard, Gloria Tridello, Jakob Passweg, Anne Kozijn, Nicola Polverelli, Inmaculada Heras, Ariadna Perez, Jaime Sanz, Dagmar Berghuis, Lourdes Vázquez, María Suárez-Lledó, Maija Itäla-Remes, Tulay Ozcelik, Isabel Iturrate Basarán, Musa Karakukcu, Mohsen Al Zahrani, Goda Choi, Marián Angeles Cuesta Casas, Montserrat Batlle MassanaAmato Viviana, Nicole Blijlevens, Arnold Ganser, Baris Kuskonmaz, Hélène Labussière-Wallet, Peter J. Shaw, Zeynep Arzu Yegin, Marta González-Vicent, Vanderson Rocha, Alina Ferster, Nina Knelange, David Navarro, Malgorzata Mikulska, Rafael de la Camara, Jan Styczynski

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Little is known about characteristics of seasonal human coronaviruses (HCoVs) (NL63, 229E, OC43, and HKU1) after allogeneic stem cell transplantation (allo-HSCT). METHODS: This was a collaborative Spanish and European bone marrow transplantation retrospective multicenter study, which included allo-HSCT recipients (adults and children) with upper respiratory tract disease (URTD) and/or lower respiratory tract disease (LRTD) caused by seasonal HCoV diagnosed through multiplex polymerase chain reaction assays from January 2012 to January 2019. RESULTS: We included 402 allo-HSCT recipients who developed 449 HCoV URTD/LRTD episodes. Median age of recipients was 46 years (range, 0.3-73.8 years). HCoV episodes were diagnosed at a median of 222 days after transplantation. The most common HCoV subtype was OC43 (n = 170 [38%]). LRTD involvement occurred in 121 episodes (27%). HCoV infection frequently required hospitalization (18%), oxygen administration (13%), and intensive care unit (ICU) admission (3%). Three-month overall mortality after HCoV detection was 7% in the whole cohort and 16% in those with LRTD. We identified 3 conditions associated with higher mortality in recipients with LRTD: absolute lymphocyte count <0.1 × 109/mL, corticosteroid use, and ICU admission (hazard ratios: 10.8, 4.68, and 8.22, respectively; P < .01). CONCLUSIONS: Seasonal HCoV after allo-HSCT may involve LRTD in many instances, leading to a significant morbidity.

Original languageEnglish
Pages (from-to)1564-1575
Number of pages12
JournalThe Journal of infectious diseases
Issue number9
Publication statusPublished - May 20 2021


  • seasonal human coronavirus
  • allogeneic hematopoietic stem cell transplantation
  • community-acquired respiratory virus
  • HCoV-229E
  • HCoV-HKU1
  • HCoV-NL63
  • HCoV-OC43
  • immunocompromised
  • immunodeficiency score index
  • multiplex PCR assay
  • upper and lower respiratory tract disease

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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