Severe Coronavirus Disease 2019 Infection in an Adolescent Patient After Hematopoietic Stem Cell Transplantation

Fisler, Grace; Haimed, Abraham; Levy, Carolyn Fein; Stiles, Jessica B.; Capone, Christine A.; Fish, Jonathan D.; Brochstein, Joel A.; Taylor, Matthew D.

doi:10.1016/j.chest.2020.05.579

Cited by 11 publications

(14 citation statements)

References 15 publications

(17 reference statements)

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“…48 Many publications suggested that the evaluation of ferritin as a syndrome and one of the main clinical parameters in COVID infection. [49][50][51] Our results have revealed a relationship between plasma phospholipid levels and the severity of COVID-19.…”

Section: Lung Ct Diagnosis Using Syngo Dual Energy Lungmentioning

confidence: 86%

Plasma Phospholipids: A Promising Simple Biochemical Parameter to Evaluate COVID-19 Infection Severity

Hussein

Ismail²,

Mohamed

et al. 2021

Bioinform Biol Insights

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Background: Coronavirus-19 (COVID-19) pandemic is a worldwide public health problem that has been known in China since December 25, 2019. Phospholipids are structural components of the mammalian cytoskeleton and cell membranes. They suppress viral attachment to the plasma membrane and subsequent replication in lung cells. In the virus-infected lung, phospholipids are highly prone to oxidation by reactive oxygen species, leading to the production of oxidized phospholipids (OxPLs). Objective: This study was carried out to explain the correlation between the level of plasma phospholipids in patients with COVID-19 infection and the levels of cytokine storms to assess the severity of the disease. Methods: Plasma samples from 34 enrolled patients with mild, moderate, and severe COVID-19 infection were collected. Complete blood count (CBC), plasma levels of D-dimer, ferritin, C-reactive protein (CRP), cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), phospholipids, secretory phospholipase A2 (sPLA2)α2, and cytokine storms were estimated, and lung computed tomography (CT) imaging was detected. Results: The CBC picture showed the presence of leukopenia, lymphopenia, and eosinopenia in patients with COVID-19 infection. Furthermore, a significant increase was found in plasma levels of D-dimer, CRP, ferritin, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and IL-13 as well as sPLA2α2 activity compared to normal persons. However, plasma levels of phospholipids decreased in patients with moderate and severe COVID-19 infection, as well as significantly decreased in levels of triacylglycerols and HDL-C in plasma from patients with severe infection only, compared to normal persons. Furthermore, a lung CT scan showed the presence of inflammation in a patient with mild, moderate, and severe COVID-19 infection. Conclusions: This study shows that there is a correlation between plasma phospholipid depletion and elevated cytokine storm in patients with COVID-19 infection. Depletion of plasma phospholipid levels in patients with COVID-19 infection is due to oxidative stress, induction of cytokine storm, and systemic inflammatory response after endothelial cell damage promote coagulation. According to current knowledge, patients with COVID-19 infection may need to administer surfactant replacement therapy and sPLA2 inhibitors to treat respiratory distress syndrome, which helps them to maintain the interconnected surfactant structures.

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Section: Lung Ct Diagnosis Using Syngo Dual Energy Lungmentioning

confidence: 86%

Plasma Phospholipids: A Promising Simple Biochemical Parameter to Evaluate COVID-19 Infection Severity

Hussein

Ismail²,

Mohamed

et al. 2021

Bioinform Biol Insights

View full text Add to dashboard Cite

show abstract

“…Recent literature advocates hyperferritinemic syndrome as one of the main modifications in COVID infection [ 14 – 19 ], suggesting evaluation of ferritin levels as a parameter of infection. Presently, excluding reviews and metanalysis, only ten papers have been published with the contemporary topic of “ferritin” and “COVID” [ 20 – 29 ].…”

Section: Discussionmentioning

confidence: 99%

Serum ferritin levels in inflammation: a retrospective comparative analysis between COVID-19 and emergency surgical non-COVID-19 patients

2021

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Background SARS-CoV-2 infection has spread worldwide, and the pathogenic mechanism is still under investigation. The presence of a huge inflammatory response, defined as “cytokine storm,” is being studied in order to understand what might be the prognostic factors implicated in the progression of the infection, with ferritin being one of such markers. The role of ferritin as a marker of inflammation is already known, and whether it changes differently between COVID and non-COVID patients still remains unclear. The aim of this retrospective analysis is to understand whether the inflammatory process in these two types is different. Methods In this retrospective analysis, we compared 17 patients affected by SARS-CoV-2, who had been admitted between February and April 2020 (group A) along with 30 patients admitted for acute surgical disease with SARS-CoV-2 negative swab (group B). A further subgroup of Covid negative patients with leukocytosis was compared to group A. Results In group A, the median (interquartile range) serum ferritin was 674 (1284) ng/mL, and it was double the cutoff (300 ng/mL) in 9 out of 17 (52%). The median (IQR) value of ferritin level in the total blood samples of group B was 231, and in the subgroup with leucocytosis, 149 (145). Group A showed a significantly higher ferritin median level compared to the entire group B (two-tailed Mann-Whitney test, p < 0.0001) as well as to the subgroup with leucocytosis (p < 0.0014). Conclusions The role of iron metabolism appears to be directly involved in COVID infection. On the other hand, in the acute inflammation of patients admitted for surgery, and probably in other common phlogistic processes, iron modifications appear to be self-limited. However, our finding suggests the use of ferritin as a marker for COVID infection.

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“…This action was done because HSCT patients are at higher risk to have COVID-19 related complications especially in the first days after the transplant because of the conditioning they received and the delayed immune reconstitution after transplant ( 32 ), as the conditioning the patients received will lead to the loss of their B and T lymphocytes including the loss of memory cells, in addition to the mucocutaneous barriers damage ( 33 ). Severe complications of COVID-19 in patients post HSCT were reported in multiple articles, Grace Fisler et al and his colleagues reported a patient who had COVID-19 on day (+8) post-transplant and she developed respiratory failure and intubation for long time ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Hematopoietic Stem Cell Transplantation During the Era of COVID-19 in Queen Rania Children's Hospital

Qatawneh¹,

Aljazazi²,

Altarawneh³

et al. 2021

Mater Sociomed

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Background: Corona virus disease 2019 (COVID-19) is causing a health crisis nowadays, and all countries are following the recommendations of the WHO to decrease the spread of the disease. Till now, few data are available regarding the clinical course, severity of the disease and the duration of infectivity of COVID-19 in patients received Hematopoietic Stem Cell Transplantation (HSCT). Objective: To evaluate the medical protocols and outcome of patients who underwent HSCT during the pandemic of COVID-19. Methods: A retrospective review of the medical files of patients who underwent hematopoietic stem cell transplantation during the era of COVID-19. The following data were reviewed for all patients: age, gender, primary disease, viral screening protocols for donors and recipients, COVID-19 status and outcome. The European society for blood and marrow transplantation (EBMT) guidelines were applied strictly on all of our patients, donors and bone marrow transplant unit staff. Results: A total of 10 children were transplanted, 8 of them received allogenic transplant from matched donor and two patients received autologous transplant. Regarding allogenic transplants, all of our patients except two were transplanted as an emergency, 2 of them were Aplastic anemia, 2 patients were Fanconi anemia, one patient was Amegakaryocytic thrombocytopenia, and one patient was Acute myeloid leukemia. Only two patients were not an emergency as one of them had Thalassemia major and the other one was Sickle cell anemia. The autologous transplant was done for two patients with Neuroblastoma stage 4 as part of their treatment protocol. At a median follow up of 5.5 months (range, 2 month-7 months) two patients (20%) developed COVID-19, which was asymptomatic in both of them. One of our patients (10%) died due to cytomegalovirus (CMV) pneumonia. No one of our patient was affected by the emergency regulations applied by the country and hospitals during the pandemic of COVID-19 virus. Conclusion: Hematopoietic stem cell transplantation can be performed safely for emergency cases, if we strictly follow the guidelines of EBMT.

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Severe Coronavirus Disease 2019 Infection in an Adolescent Patient After Hematopoietic Stem Cell Transplantation

Cited by 11 publications

References 15 publications

Plasma Phospholipids: A Promising Simple Biochemical Parameter to Evaluate COVID-19 Infection Severity

Plasma Phospholipids: A Promising Simple Biochemical Parameter to Evaluate COVID-19 Infection Severity

Serum ferritin levels in inflammation: a retrospective comparative analysis between COVID-19 and emergency surgical non-COVID-19 patients

Hematopoietic Stem Cell Transplantation During the Era of COVID-19 in Queen Rania Children's Hospital

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