Clinical Significance of Human Coronavirus in Bronchoalveolar Lavage Samples From Hematopoietic Cell Transplant Recipients and Patients With Hematologic Malignancies.
The possible role of human coronavirus (HCoV) in lower respiratory tract disease (LRTD) in hematopoietic cell transplant (HCT) recipients and patients with hematologic malignancies (HM) has not been well studied.
We conducted a retrospective review of HCT/HM patients with HCoV detected in bronchoalveolar lavage (BAL). HCoV strains were identified in BAL samples using strain-specific polymerase chain reaction. Mortality rates were compared among HCT recipients with LRTD caused by HCoV, respiratory syncytial virus (RSV), influenza virus, or parainfluenza virus (PIV) by multivariable Cox regression analysis.
We identified 35 patients (37 episodes) with HCoV LRTD. Among 23 available BAL samples, 48% were strain OC43, 22% were NL63, 17% were 229E, and 13% were HKU1. Overall, 21 patients (60%) required oxygen therapy at diagnosis and 19 (54%) died within 90 days of diagnosis. Respiratory copathogens were detected in 21 episodes (57%), including viruses (n = 12), fungi (n = 10), and bacteria (n = 8). Mortality rates were not different between patients with and without copathogens (P = .65). In multivariable models, mortality associated with HCoV LRTD was similar to that seen with RSV, influenza, and PIV LRTD in HCT recipients (adjusted hazard ratio, 1.34 [95% confidence interval, .66-2.71], P = .41 vs RSV, adjusted for cell source, cytopenia, copathogens, oxygen use, and steroid use).
HCoV LRTD in patients with HCT or HM is associated with high rates of oxygen use and mortality. Mortality associated with HCoV LRTD in HCT recipients appears to be similar to that seen with RSV, influenza virus, and PIV.
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center.|Department of Pediatrics, University of Washington.|Pediatric Infectious Diseases Division, Seattle Children's Hospital.
Chikara
C
Ogimi
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center.|Department of Pediatrics, University of Washington.|Pediatric Infectious Diseases Division, Seattle Children's Hospital.
Alpana A
AA
Waghmare
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center.|Department of Laboratory Medicine, University of Washington.
Jane M
JM
Kuypers
Clinical Research Division and.
Hu
H
Xie
Clinical Research Division and.|Molecular Oncology Laboratory, Fred Hutchinson Cancer Research Center, and.
Cecilia C
CC
Yeung
Clinical Research Division and.|Department of Biostatistics, University of Washington, Seattle, Washington.
Wendy M
WM
Leisenring
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center.|Department of Hematology and Oncology, National Cancer Research Center East, Chiba, Japan.
Sachiko
S
Seo
Department of Internal Medicine, College of Medicine, Catholic University of Korea, Seoul; and.
Su-Mi
SM
Choi
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center.|Department of Laboratory Medicine, University of Washington.
Keith R
KR
Jerome
Department of Pediatrics, University of Washington.|Pediatric Infectious Diseases Division, Seattle Children's Hospital.
Janet A
JA
Englund
Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center.|Clinical Research Division and.|Department of Medicine, University of Washington, Seattle.
Michael
M
Boeckh
D000293:Adolescent; D000328:Adult; D000368:Aged; D018893:Bronchoalveolar Lavage; D001992:Bronchoalveolar Lavage Fluid / Q000821:virology*; D002648:Child; D017934:Coronavirus / Q000235:genetics / Q000302:isolation & purification*; D018352:Coronavirus Infections / Q000150:complications* / Q000401:mortality / Q000821:virology; D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications / Q000401:mortality / Q000821:virology*; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D006801:Humans; D007251:Influenza, Human / Q000821:virology; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D018357:Respiratory Syncytial Virus Infections / Q000150:complications / Q000401:mortality / Q000821:virology; D012141:Respiratory Tract Infections / Q000150:complications / Q000821:virology; D012189:Retrospective Studies; D055815:Young Adult
bronchoalveolar lavage; hematologic malignancy.; hematopoietic cell transplant; human coronavirus; lower respiratory tract disease