Table 3.
Disease Severity, Treatments, and Outcomes of COVID-19 in HCT and CAR-T Cell Therapy Recipients
| Characteristic | Total | Type of Cellular Therapy | P value | ||
|---|---|---|---|---|---|
| Allo-HCT | Auto-HCT | CAR-T | |||
| Number at risk (HCT/CAR-T performed 01/2019-05/2021), n | 756 | 286 | 373 | 97 | |
| Incidence of SARS-CoV-2 infection, n (%) | 58 (8) | 32 (11) | 23 (6) | 3 (3) | |
| Age, yr, median (range) | 58 (24-77) | 56 (24-73) | 65 (24-77) | 60 (51-75) | .188 |
| Time since HCT/CAR-T, mo, median (range) | 17.7 (0.2-201.9) | 17.3 (1-201.9) | 23.9 (0.2-118.7) | 2.6 (2.3-4.8) | .407 |
| COVID-19 diagnosis in first 100 d post-HCT/CAR-T, n (%) | 13 (22) | 8 (25) | 3 (13) | 2 (67) | .097 |
| COVID-19 severity, n (%) | |||||
| Mild | 29 (50) | 11 (34) | 16 (70) | 2 (67) | .013 |
| Moderate | 13 (22) | 10 (31) | 3 (13) | 0 | |
| Severe | 7 (12) | 2 (6) | 4 (17) | 1 (33) | |
| Critical/fatal | 9 (16) | 9 (28) | 0 | 0 | |
| Abnormal chest imaging, n (%) | 29 (50) | 21 (67) | 7 (30) | 1 (33) | .030 |
| Hypoxia, n (%) | 16 (28) | 11 (34) | 4 (17) | 1 (33) | .371 |
| ICU admission, n (%) | 11 (19) | 9 (28) | 2 (9) | 0 | .133 |
| Mechanical ventilation, n (%) | 6 (10) | 5 (16) | 1 (4) | 0 | .333 |
| COVID-19 therapy, n (%) | |||||
| Remdesivir | 24 (41) | 20 (63) | 3 (13) | 1 (33) | .001 |
| Convalescent plasma | 20 (35) | 16 (50) | 3 (13) | 1 (33) | .017 |
| Dexamethasone | 13 (22) | 10 (31) | 2 (9) | 1 (33) | .127 |
| Monoclonal antibodies | 11 (19) | 8 (25) | 2 (9) | 1 (33) | .254 |
| Tocilizumab | 2 (3) | 2 (6) | 0 | 0 | .431 |
| Time to clear SARS-CoV-2 infection, wk, median (range)* | 7.7 (2.0-18.7) | 7.6 (2.0-18.7) | 7.8 (2.6-16.9) | NA | .480 |
| Follow-up after COVID-19, mo, median (range) | 6.1 (0.5-13.6) | 5.5 (0.5-12.4) | 6.4 (3.4-13.6) | 5.7 (4.4-8.9) | .025 |
| Outcomes, n (%) | |||||
| Recovered | 47 (81) | 23 (72) | 23 (100) | 1 (33) | <.001 |
| Persistent | 2 (3) | 0 | 0 | 2 (67) | |
| Dead | 9 (16) | 9 (28) | 0 | 0 | |
NA indicates Not available.
Abbreviations: COVID-19, coronavirus disease 2019; HCT, hematopoietic stem cell transplant; Allo, allogeneic; Auto, autologous; CAR-T, chimeric antigen receptor-T cell therapy; ICU, intensive care unit.
⁎
Data available for 38 patients.
†Data available for 2 of 3 patients, both of whom had B cell aplasia and persistent SARS-CoV-2 PCR positive (first positive, 12/8/2020 and 1/16/2021, respectively).