Biobehavioral Implications of Covid-19 for Transplantation and Cellular Therapy Recipients

Frontiers in Immunology

卷:13

Hermioni L. Amonoo²  Lathika Mohanraj³  Debra Lynch Kelly⁵  Erin S. Costanzo⁶  Natalie S. McAndrew⁷  Ashley M. Nelson⁸  Jennifer M. Knight⁹  Mallory R. Taylor¹⁰  Hannah A. Uttley¹²  Elisabeth C. Henley¹²  Lucie M. Turcotte¹³  Kelly E. Rentscher¹⁵ 

[1] Immunology, Medical College of Wisconsin, Milwaukee, WI, United States;

[2] The Medical College of Wisconsin, Milwaukee, WI, United States;

[3] 0Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, United States;

[4] 1Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States;

[5] 2Department of Adult Health and Nursing Systems, School of Nursing, Virginia Commonwealth University, Richmond, VA, United States;

[6] 3Department of Nursing, University of Florida, Gainesville, FL, United States;

[7] College of Nursing, University of Wisconsin – Milwaukee, Milwaukee, WI, United States;

[8] Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, United States;

[9] Department of Microbiology &

[10] Department of Pediatrics, Division of Hematology/Oncology, University of Washington School of Medicine, Seattle, WA, United States;

[11] Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, United States;

[12] Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, United States;

[13] Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, Boston, MA, United States;

[14] Froedtert Hospital, Froedtert &

[15] Palliative Care and Resilience Program, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, United States;

关键词: transplantation and cellular therapy;    biobehavioral;    stress;    Covid-19;    outcomes;   

DOI  :  10.3389/fimmu.2022.877558

来源: DOAJ

【 摘 要 】

A growing body of literature has emphasized the importance of biobehavioral processes – defined as the interaction of behavior, psychology, socioenvironmental factors, and biological processes – for clinical outcomes among transplantation and cellular therapy (TCT) patients. TCT recipients are especially vulnerable to distress associated with pandemic conditions and represent a notably immunocompromised group at greater risk for SARS-CoV-2 infection with substantially worse outcomes. The summation of both the immunologic and psychologic vulnerability of TCT patients renders them particularly susceptible to adverse biobehavioral sequelae associated with the Covid-19 pandemic. Stress and adverse psychosocial factors alter neural and endocrine pathways through sympathetic nervous system and hypothalamic-pituitary-adrenal axis signaling that ultimately affect gene regulation in immune cells. Reciprocally, global inflammation and immune dysregulation related to TCT contribute to dysregulation of neuroendocrine and central nervous system function, resulting in the symptom profile of depression, fatigue, sleep disturbance, and cognitive dysfunction. In this article, we draw upon literature on immunology, psychology, neuroscience, hematology and oncology, Covid-19 pathophysiology, and TCT processes to discuss how they may intersect to influence TCT outcomes, with the goal of providing an overview of the significance of biobehavioral factors in understanding the relationship between Covid-19 and TCT, now and for the future. We discuss the roles of depression, anxiety, fatigue, sleep, social isolation and loneliness, and neurocognitive impairment, as well as specific implications for sub-populations of interest, including pediatrics, caregivers, and TCT donors. Finally, we address protective psychological processes that may optimize biobehavioral outcomes affected by Covid-19.

【 授权许可】

Unknown