Posthematopoietic stem cell transplant COVID‐19 infection in a pediatric patient with IPEX syndrome

• Published in: Pediatric Blood & Cancer 2021-01, Vol.68 (1), p.e28578-n/a
• Main Authors: Alicea Marrero, Minelys M., Silio, Margarita, McQueen‐Amaker, Katie, Español, María, Velez, María, LeBlanc, Zachary
• Format: Article
• Language: English
• Subjects: Allografts; Child; COVID-19 - blood; COVID-19 - diagnostic imaging; COVID-19 - microbiology; COVID-19 - therapy; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - congenital; Diabetes Mellitus, Type 1 - diagnostic imaging; Diabetes Mellitus, Type 1 - microbiology; Diabetes Mellitus, Type 1 - therapy; Diarrhea - blood; Diarrhea - diagnostic imaging; Diarrhea - microbiology; Diarrhea - therapy; Fatal Outcome; Genetic Diseases, X-Linked - blood; Genetic Diseases, X-Linked - diagnostic imaging; Genetic Diseases, X-Linked - microbiology; Genetic Diseases, X-Linked - therapy; Graft Rejection - blood; Graft Rejection - diagnostic imaging; Graft Rejection - microbiology; Graft Rejection - therapy; Hematopoietic Stem Cell Transplantation; Humans; Immune System Diseases - blood; Immune System Diseases - congenital; Immune System Diseases - diagnostic imaging; Immune System Diseases - microbiology; Immune System Diseases - therapy; Letter to the Editor; Letters to the Editor; Male; SARS-CoV-2 - metabolism
• ISSN: 1545-5009; 1545-5017
• DOI: 10.1002/pbc.28578

The antiviral remdesivir10 has been shown to improve overall mortality in patients treated for COVID‐19,1 and was approved by the United States Food and Drug Administration (FDA) for hospitalized patients with severe disease.2 Tocilizumab, a humanized antiinterleukin‐6 receptor11 antibody, can hasten COVID‐19‐related cytokine release syndrome recovery by 75%.3 Implementation of COVID‐19 convalescent plasma (CCP) in the treatment of COVID‐19 infection was also suggested by the FDA.4 An 8‐year‐old African‐American male with immune‐dysregulation polyendocrinopathy X‐linked (IPEX) syndrome underwent haploidentical, related bone marrow hematopoietic stem cell transplant (HSCT), and contracted SARS‐CoV‐2 during the periengraftment period, subsequently developing primary graft failure. First dose of remdesivir. bFirst dose of tocilizumab. 26 14 272 1.04 780 11.8 17.11 Day 2c c a Note. First dose of remdesivir. [...]dose of tocilizumab. 27 13 619 2.39 1019 16.2 16.5 Day 3d d a Note. First dose of remdesivir. First dose of remdesivir. First dose of remdesivir. bFirst dose of tocilizumab. c a Note. First dose of remdesivir. [...]dose of tocilizumab. d a Note. First dose of remdesivir. First dose of remdesivir. A case report depicted two adult posttransplant patients with adequate graft function, on immunosuppressive therapy, that eventually died after developing multiorgan failure.7 Our patient was treated aggressively, and we attributed the first decreasing trend in inflammatory markers (Table 1) to achieving disease control.