Research Horizons


Exploring Intersections Between COVID-19 and Co-Morbidities

Much political discussion about the pandemic revolved around whether otherwise healthy people were dying from SARS-CoV-2 infections or whether the virus was a final straw of sorts for people with pre-existing conditions. For children with chronic disease, this was much more serious than a political debate.

This issue cut across many conditions, including diabetes, lung diseases, blood disorders and many rare chronic conditions. At Cincinnati Children’s, experts quickly dove into questions about how to manage infected children already immunosuppressed as organ or bone marrow transplant recipients.

Christopher Dandoy, MD, MSc, was a co-author in a large observational study, published in March 2021 in The Lancet Haematology, that analyzed outcomes for 318 stem-cell transplant patients who were affected by COVID-19.

Of those who caught the virus, 45 needed mechanical ventilation. More than 30% of transplant recipients died within a month of infection with COVID. Older age and male sex increased mortality risk. Those with lymphomas also fared worse compared to those with myelomas.

Lara Danziger-Isakov, MD, MPH, was the senior author for an outspoken group of experts who urged placing higher priority on vaccination for transplant patients in an article published online in January 2021 in the Journal of Heart and Lung Transplantation.

“Our transplant recipients are far more likely to suffer a severe outcome from COVID-19 than from the vaccine,” the co-authors stated. “Transplant recipients with COVID-19 had a 30% increased risk of death or mechanical ventilation compared with matched controls.” Protecting these children “now hinges on widespread acceptance of the vaccines. In a pandemic marked by political divisions, misinformation exponentially amplified by social media, and an undercurrent of distrust of science, we believe it is critical that we engage our patients to encourage vaccination as soon as it is available.”

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