Tali Shafat, Amy Spallone, Fareed Khawaja, Ying Jiang, Jennifer Jackson, Lior Nesher, Roy F Chemaly
{"title":"2023-2024年呼吸道病毒季节，呼吸道合胞病毒下呼吸道感染和恶性血液病患者死亡率高于SARS-CoV-2和流感。","authors":"Tali Shafat, Amy Spallone, Fareed Khawaja, Ying Jiang, Jennifer Jackson, Lior Nesher, Roy F Chemaly","doi":"10.1111/tid.70113","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Respiratory viral infections (RVIs) significantly impact patients with hematologic malignancies (HMs). During the 2023-2024 respiratory viral (RV) season, we observed a decline in SARS-CoV-2-related hospitalizations in our center compared to the two previous seasons. Given the changing epidemiology of RVIs in the post-pandemic era, the low acceptance of SARS-CoV-2 and influenza vaccination, and the availability of new respiratory syncytial virus (RSV) vaccines in 2023, we aimed to compare outcomes of RSV, influenza, and SARS-CoV-2 infections in patients with HMs during the 2023-2024 RV season.</p><p><strong>Methods: </strong>We retrospectively analyzed adults with HMs diagnosed with RSV, influenza, or SARS-CoV-2 between October 2023 and April 2024. The primary outcomes were lower respiratory tract infection (LRI), hospitalization, and 30-day all-cause mortality.</p><p><strong>Results: </strong>We identified 503 patients with 536 consecutive RVIs: 50.0% with SARS-CoV-2, 26.1% with RSV, and 22.2% with influenza (1.7% co-infections). Among RSV-infected patients, 50.7% developed LRI, compared to 41.2% with influenza and 39.2% with SARS-CoV-2 (p = 0.076). The 30-day all-cause mortality was 9.3% for RSV, 7.6% for influenza, and 3.4% for SARS-CoV-2 (p = 0.037). In the multivariable analysis, RSV was associated with higher LRI rate compared to SARS-CoV-2, along with older age, refractory/relapsed cancer, nosocomial infections, and lymphopenia. Older age, allogeneic hematopoietic cell transplantation, nosocomial infections, and LRIs were associated with increased mortality.</p><p><strong>Conclusions: </strong>During the 2023-2024 RV season, the clinical impact of these viruses on patients with HMs remains significant, with higher morbidity and mortality from RSV, highlighting the persistent unmet need for better management strategies for RVIs in the post-pandemic era.</p>","PeriodicalId":23318,"journal":{"name":"Transplant Infectious Disease","volume":" ","pages":"e70113"},"PeriodicalIF":2.6000,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Respiratory Syncytial Virus Exceeded SARS-CoV-2 and Influenza in Lower Respiratory Infection and Mortality Rates Among Patients With Hematologic Malignancies During the 2023-2024 Respiratory Virus Season.\",\"authors\":\"Tali Shafat, Amy Spallone, Fareed Khawaja, Ying Jiang, Jennifer Jackson, Lior Nesher, Roy F Chemaly\",\"doi\":\"10.1111/tid.70113\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Respiratory viral infections (RVIs) significantly impact patients with hematologic malignancies (HMs). During the 2023-2024 respiratory viral (RV) season, we observed a decline in SARS-CoV-2-related hospitalizations in our center compared to the two previous seasons. Given the changing epidemiology of RVIs in the post-pandemic era, the low acceptance of SARS-CoV-2 and influenza vaccination, and the availability of new respiratory syncytial virus (RSV) vaccines in 2023, we aimed to compare outcomes of RSV, influenza, and SARS-CoV-2 infections in patients with HMs during the 2023-2024 RV season.</p><p><strong>Methods: </strong>We retrospectively analyzed adults with HMs diagnosed with RSV, influenza, or SARS-CoV-2 between October 2023 and April 2024. The primary outcomes were lower respiratory tract infection (LRI), hospitalization, and 30-day all-cause mortality.</p><p><strong>Results: </strong>We identified 503 patients with 536 consecutive RVIs: 50.0% with SARS-CoV-2, 26.1% with RSV, and 22.2% with influenza (1.7% co-infections). Among RSV-infected patients, 50.7% developed LRI, compared to 41.2% with influenza and 39.2% with SARS-CoV-2 (p = 0.076). The 30-day all-cause mortality was 9.3% for RSV, 7.6% for influenza, and 3.4% for SARS-CoV-2 (p = 0.037). In the multivariable analysis, RSV was associated with higher LRI rate compared to SARS-CoV-2, along with older age, refractory/relapsed cancer, nosocomial infections, and lymphopenia. Older age, allogeneic hematopoietic cell transplantation, nosocomial infections, and LRIs were associated with increased mortality.</p><p><strong>Conclusions: </strong>During the 2023-2024 RV season, the clinical impact of these viruses on patients with HMs remains significant, with higher morbidity and mortality from RSV, highlighting the persistent unmet need for better management strategies for RVIs in the post-pandemic era.</p>\",\"PeriodicalId\":23318,\"journal\":{\"name\":\"Transplant Infectious Disease\",\"volume\":\" \",\"pages\":\"e70113\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-10-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transplant Infectious Disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/tid.70113\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplant Infectious Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/tid.70113","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Respiratory Syncytial Virus Exceeded SARS-CoV-2 and Influenza in Lower Respiratory Infection and Mortality Rates Among Patients With Hematologic Malignancies During the 2023-2024 Respiratory Virus Season.
Background: Respiratory viral infections (RVIs) significantly impact patients with hematologic malignancies (HMs). During the 2023-2024 respiratory viral (RV) season, we observed a decline in SARS-CoV-2-related hospitalizations in our center compared to the two previous seasons. Given the changing epidemiology of RVIs in the post-pandemic era, the low acceptance of SARS-CoV-2 and influenza vaccination, and the availability of new respiratory syncytial virus (RSV) vaccines in 2023, we aimed to compare outcomes of RSV, influenza, and SARS-CoV-2 infections in patients with HMs during the 2023-2024 RV season.
Methods: We retrospectively analyzed adults with HMs diagnosed with RSV, influenza, or SARS-CoV-2 between October 2023 and April 2024. The primary outcomes were lower respiratory tract infection (LRI), hospitalization, and 30-day all-cause mortality.
Results: We identified 503 patients with 536 consecutive RVIs: 50.0% with SARS-CoV-2, 26.1% with RSV, and 22.2% with influenza (1.7% co-infections). Among RSV-infected patients, 50.7% developed LRI, compared to 41.2% with influenza and 39.2% with SARS-CoV-2 (p = 0.076). The 30-day all-cause mortality was 9.3% for RSV, 7.6% for influenza, and 3.4% for SARS-CoV-2 (p = 0.037). In the multivariable analysis, RSV was associated with higher LRI rate compared to SARS-CoV-2, along with older age, refractory/relapsed cancer, nosocomial infections, and lymphopenia. Older age, allogeneic hematopoietic cell transplantation, nosocomial infections, and LRIs were associated with increased mortality.
Conclusions: During the 2023-2024 RV season, the clinical impact of these viruses on patients with HMs remains significant, with higher morbidity and mortality from RSV, highlighting the persistent unmet need for better management strategies for RVIs in the post-pandemic era.
期刊介绍：
Transplant Infectious Disease has been established as a forum for presenting the most current information on the prevention and treatment of infection complicating organ and bone marrow transplantation. The point of view of the journal is that infection and allograft rejection (or graft-versus-host disease) are closely intertwined, and that advances in one area will have immediate consequences on the other. The interaction of the transplant recipient with potential microbial invaders, the impact of immunosuppressive strategies on this interaction, and the effects of cytokines, growth factors, and chemokines liberated during the course of infections, rejection, or graft-versus-host disease are central to the interests and mission of this journal.
Transplant Infectious Disease is aimed at disseminating the latest information relevant to the infectious disease complications of transplantation to clinicians and scientists involved in bone marrow, kidney, liver, heart, lung, intestinal, and pancreatic transplantation. The infectious disease consequences and concerns regarding innovative transplant strategies, from novel immunosuppressive agents to xenotransplantation, are very much a concern of this journal. In addition, this journal feels a particular responsibility to inform primary care practitioners in the community, who increasingly are sharing the responsibility for the care of these patients, of the special considerations regarding the prevention and treatment of infection in transplant recipients. As exemplified by the international editorial board, articles are sought throughout the world that address both general issues and those of a more restricted geographic import.
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