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Asymptomatická infekce SARS-CoV-2 u příjemců hematopoetických kmenových buněk v období cirkulace varianty omikron


Authors: M. Šťastná-Marková;  K. Roubalová;  P. Hainz;  J. Kryštofová;  K. Labská;  T. Vosáhlová;  Š. Němečková
Authors‘ workplace: Transplantation and Intensive Care Unit, Institute of Hematology and Blood Transfusion, Prague, Czech Republic 1;  Department of Immunology, Institute of Hematology and Blood Transfusion, Prague, Czech Republic 2;  Laboratory of Molecular Microbiology, Institute of Hematology and Blood Transfusion, Prague, Czech Republic 3;  Department of Non-commercial Clinical Studies, Institute of Hematology and Blood Transfusion, Prague, Czech Republic 4;  Science and Research Centre, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic 5
Published in: Epidemiol. Mikrobiol. Imunol. 73, 2024, č. 3, s. 140-146
Category: Original Papers
doi: https://doi.org/10.61568/emi/11-6352/20240726/138065

Overview

Cíl: Zaměřili jsme se na stanovení prevalence infekce SARS-CoV-2 se symptomatickým nebo asymptomatickým průběhem a na identifikaci prediktorů symptomatické nebo asymptomatické infekce SARS-CoV-2 u pacientů během sedmi měsíců následujících po transplantaci alogenních hematopoetických kmenových buněk (alo-HSCT) v období cirkulace varianty omikron.

Metody: Prevalence proběhlé infekce SARS-CoV-2 byla detekována u pacientů během sedmi měsíců po allo-HSCT v omikronovém období pomocí buněčné a humorální imunitní odpovědi proti nukleoproteinu SARS-CoV-2 (NCP).

Výsledky: Pozitivní markery prodělané infekce byly identifikovány u 45,2 % pacientů (n = 42). Infekce byla asymptomatická u 68,4 % pacientů s anti-NCP pozitivitou. Hledání rizikových faktorů pro symptomatickou infekci SARS-CoV-2 u příjemců alo-HSCT odhalilo, že nízká úroveň rekonstituce B buněk byla jediným signifikantně souvisejícím rizikovým faktorem.

Závěr: Vysoký podíl příjemců alo-HSCT, kteří byli asymptomaticky infikováni do sedmi měsíců po transplantaci v letech 2022–2023, přestože byli imunokompromitovaní a neočkovaní, ukazuje na oslabení cirkulujícího viru a může signalizovat pro pacienty po transplantaci menší riziko onemocnění SARS-CoV-2 v omikronovém období. Ukázalo se, že očkování těchto pacientů proti SARS-

-CoV-2 je spojeno s nízkým, ale významným rizikem exacerbace vyléčené chronické reakce štěpu proti hostiteli (GVHD – Graft Versus Host Disease) a s rizikem de novo GVHD. Nízká úroveň rekonstituce B-buněk byla jediným významným rizikovým faktorem pro symptomatickou infekci SARS-CoV-2 u příjemců alo-HSCT.

Klíčová slova:

asymptomatická infekce SARS-CoV-2 – alogenní transplantace hematopoetických kmenových buněk – varianta omikron – odpověď T buněk – nukleoprotein


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Acknowledgement

The authors acknowledge the European Regional Development Fund (ERDF) for project AIIHHPCZ.02.1.01/0.0/0.0/16_025/0007428, OPRDE, the Agency for Medical Research of the Czech Republic (AZV ČR) for project NU22-E-138, and project MH CZ – DRO (IHBT – 00023736).

We acknowledge the source of the data on the Covid-19 epidemic in the Czech Republic, which is accessible through the Ministry of Health of the Czech Republic [Internet]. 2020. Covid-19 in the Czech Republic: Open datasets and datasets for download. https://onemocneni-aktualne.mzcr.cz/api/v2/covid-19 [12].

We gratefully acknowledge the European center for disease control (ECDC) as the original source of the data describing the distribution of variants of concern (VOC) by week and country accessible on web pages © ECDC [2005–2023].

Do redakce došlo dne 21. 5. 2024.

Adresa pro korespondenci:
RNDr. Šárka Němečková, DrSc.

Ústav hematologie a krevní transfuze
U Nemocnice 504/1 120 00 Praha 2
e-mail:
sarka.nemeckova@uhkt.cz

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