ISSN 1866-8836
Клеточная терапия и трансплантация

PI-02. Conducting allo-HSCT in children under the conditions of COVID-19 pandemic

Natalia P. Gusleva, Olga O. Molostova, Olga V. Pimenova, Larisa N. Shelikhova, Michael A. Maschan

Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia


Contact: Natalia P. Gusleva, phone: +7 (929) 594-24-62, e-mail: natalja-leshhuk@rambler.ru

doi 10.18620/ctt-1866-8836-2022-11-3-1-132

Summary

Coronavirus infection (COVID-19) caused by the severe acute respiratory syndrome virus, SARS-CoV-2, is among the most serious problems in the 21st century, a threat to public health worldwide. The COVID-19 pandemic is still active in the vast majority of countries. Based on WHO statistics, children are less susceptible to COVID-19 than adults. However, pediatric patients with oncological and hematological diseases are at risk due to a pronounced weakening of immunity caused by chemotherapy or bone marrow transplantation. The objective of our study was to analyze the data of patients who received allogeneic hematopoietic stem cell transplantation (HSCT) over 2020-2022 and had a coronavirus infection, in order to assess the role of medical nurses in prevention of the infection spread, and in treatment of HSC recipients during the COVID-19 pandemic as well as to consider clinical cases of HSCT recipients who contracted the COVID-19.

Materials and methods

From January 2020 to September 2022, 400 allogeneic transplants of hematopoietic stem cells were performed at the Dmitry Rogachev Centre. Sixteen patients (14 diagnosed with ALL; 2, with acquired aplastic anemia) experienced coronavirus infection at early or late terms after HSCT. Two patients with acute lymphoblastic leukemia with positive PCR tests in bronchoalveolar lavage without clinical signs of COVID-19 still underwent allogeneic HSCT for urgent indications. During the pandemic, the center developed recommendations for the prevention of coronavirus infection, as well as introduced a special monitoring regimen for the COVID patients. The patients with positive PCR test were isolated in separate boxes with a special nursing station. The nursing shifts were arranged in compliance with individual staff protective measures. Thus, the nurses working with these patients did not contact with the COVID-free patients. In turn, the compliance with individual protection measures, separate staying of the nurses at the workplace, as well as timely vaccination, ensured the safety of medical personnel.

Results

During the COVID-19 pandemic, our center performed 400 HSCT, thus fully maintaining their activities. In the absence of clear recommendations for the management of immunocompromised patients with coronavirus infection, we were able to prevent the mass spread of infection, due to the rules developed inside the center and strict compliance with these measures. Only 4% of patients (16 cases before HSCT and 2, after HSCT) suffered with COVID-19.

Conclusion

The COVID-19 pandemic has become a challenge to medical staff, in particular, to nurses who daily provided care to the patients with acquired immunodeficiencies. Over 2.5 years, the nurses have studied recommendations for the prevention of COVID-19 spread, mastered new working skills, i.e., strict contact-aerosol isolation of patients, COVID-19 monitoring, work in the pre-hospital area and the sick patient’s boxes, monitoring the vital parameters in the patients. Nurses were also given an important role in explaining and clearly observing all cautions and hygienic rules to the patient caregivers.

Keywords

COVID-19, SARS-CoV-2, coronavirus infection, HSCT, HSC recipients, nurses.


Volume 11, Number 3
10/31/2022

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doi 10.18620/ctt-1866-8836-2022-11-3-1-132

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