Baseline Characteristics and Clinical Outcomes Following Viral Infection (Influenza and Respiratory Syncytial Virus), by Baseline Hematological Malignancy
| Variablea . | Lymphoma (n = 193) . | Multiple Myeloma (n = 297) . | P Value . |
|---|---|---|---|
| Demographics | |||
| Age at RVI diagnosis, y, mean ± SD | 58.3 ± 17.0 | 64.0 ± 10.7 | <.001 |
| Sex | |||
| Female | 79 (40.9) | 137 (46.1) | .258 |
| Male | 114 (59.1) | 160 (53.9) | |
| Race/ethnicity | |||
| Non-Hispanic White | 126 (65.3) | 151 (50.8) | <.001 |
| Hispanic | 37 (19.2) | 51 (17.2) | |
| Black | 15 (7.8) | 77 (25.9) | |
| Asian | 13 (6.7) | 16 (5.4) | |
| Other | 2 (1.0) | 2 (0.7) | |
| Smoking statusb | |||
| Never | 130 (67.7) | 184 (62.0) | .096 |
| Former | 54 (28.1) | 107 (36.0) | |
| Current | 8 (4.2) | 6 (2.0) | |
| Influenza vaccination (current season) | 30 (15.5) | 100 (33.7) | <.001 |
| HM characteristics | |||
| Active malignancy at RVI diagnosis | 112 (58.0) | 239 (80.5) | <.001 |
| Active antineoplastic treatment at RVI diagnosis | 130 (67.4) | 255 (85.9) | <.001 |
| Steroid use within 30 d of RVI diagnosis (mg prednisone equivalent) | |||
| Any | 80 (41.5) | 216 (72.7) | <.001 |
| 30-d cumulative steroid dosage, median (IQR)c | 500 (160–907) | 533 (267–1066) | .063 |
| Peak dose ≤1 mg/kg/dd (n = 295) | 38 (47.5) | 48 (22.3) | <.001 |
| Peak dose >1 mg/kg/dd | 42 (52.5) | 167 (77.7) | |
| Previous chest radiotherapy | 31 (16.1) | 65 (21.9) | .113 |
| History of HCT | |||
| None | 161 (83.4) | 105 (35.4) | <.001 |
| Autologous | 25 (13.0) | 189 (63.6) | |
| Allogeneic | 7 (3.6) | 3 (1.0) | |
| History of CAR-T therapy | 18 (9.3) | 18 (6.1) | .176 |
| RVI clinical course | |||
| Pathogen | |||
| RSV | 81 (42.0) | 151 (50.9) | .155 |
| Influenza | 111 (57.5) | 145 (48.8) | |
| RSV + influenza | 1 (0.5) | 1 (0.3) | |
| Respiratory viral coinfection (during ±2 wk) | 37 (19.2) | 48 (16.2) | .390 |
| Site of infection at presentation | |||
| URI | 131 (67.9) | 172 (57.9) | .027 |
| LRI | 62 (32.1) | 125 (42.1) | |
| Progression to LRI (among URI)e | 9 (6.9) | 10 (5.8) | .707 |
| Total LRI (presentation and progression) | 71 (36.8) | 135 (45.5) | .058 |
| LRI typef | |||
| Probable | 52 (73.2) | 118 (87.4) | .001 |
| Laboratory confirmed | 19 (26.8) | 17 (12.6) | |
| Year of infection | |||
| 2016 | 13 (6.8) | 32 (10.8) | .029 |
| 2017 | 50 (25.9) | 48 (16.2) | |
| 2018 | 29 (15.0) | 44 (14.8) | |
| 2019 | 51 (26.5) | 64 (21.5) | |
| 2020 | 18 (9.3) | 35 (11.8) | |
| 2021 | 13 (6.7) | 23 (7.7) | |
| 2022 | 19 (9.8) | 51 (17.2) | |
| Time period of infection | |||
| Pre–COVID-19 era (Jan 2016–Mar 2020) | 159 (82.4) | 217 (73.1) | .017 |
| COVID-19 era (Mar 2020–Dec 2022) | 34 (17.6) | 80 (26.9) | |
| RVI symptoms | |||
| Cough | 164 (85.0) | 264 (88.9) | .203 |
| Fever | 97 (50.3) | 153 (51.5) | .786 |
| Shortness of breath | 56 (29.0) | 106 (35.7) | .125 |
| Rhinorrhea | 63 (32.6) | 85 (28.6) | .343 |
| Nasal congestion | 62 (32.1) | 89 (30.0) | .613 |
| Fatigue | 66 (34.2) | 83 (27.9) | .142 |
| Sore throat | 30 (15.5) | 43 (14.5) | .746 |
| Chills | 29 (15.0) | 52 (17.5) | .470 |
| Headache | 22 (11.4) | 32 (10.8) | .829 |
| Nausea/vomiting | 23 (11.9) | 32 (10.8) | .695 |
| Myalgia | 22 (11.4) | 24 (8.1) | .219 |
| Diarrhea | 15 (7.8) | 23 (7.7) | .991 |
| Chest pain | 14 (7.3) | 19 (6.4) | .712 |
| Arthralgia | 7 (3.6) | 7 (2.4) | .410 |
| Hypoxia at presentation (≤92%) in room airg | 17 (9.3)h | 32 (11.4)i | .476 |
| Nosocomial infection | 10 (5.2) | 10 (3.4) | .321 |
| Lymphopenia (<200 cells/mL) | 21 (10.9) | 39 (13.1) | .458 |
| Neutropenia (<500 cells/mL) | 17 (8.8) | 11 (3.7) | .017 |
| Lymphopenia and neutropenia | 8 (4.1) | 9 (3.0) | .510 |
| Elevated creatinine (≥1.2 mg/dL) | 37 (19.2) | 109 (36.7) | <.001 |
| RVI outcomes | |||
| Hospital admission | |||
| Any | 100 (51.8) | 180 (60.6) | .055 |
| Secondary to RVI | 77 (39.9) | 155 (52.2) | .008 |
| Length of stay, d, median (IQR)j | 6 (3–9) | 5 (3–9) | .429 |
| ICU admission | 19 (9.8) | 19 (6.4) | .163 |
| Oxygen requirement (maximal) | |||
| None | 143 (74.1) | 189 (63.6) | .031 |
| Nasal cannula | 27 (14.0) | 71 (23.9) | |
| Face mask | 2 (1.0) | 6 (2.0) | |
| HFNC | 9 (4.7) | 11 (3.7) | |
| BiPAP | 3 (1.6) | 12 (4.0) | |
| Mechanical ventilation | 9 (4.7) | 8 (2.7) | |
| Antiviral timing from symptom onset | |||
| No treatment | 48 (24.9) | 52 (17.5) | .073 |
| Within 48 h | 57 (29.5) | 82 (27.6) | |
| After 48 h | 88 (45.6) | 163 (54.9) | |
| Antiviral therapy | |||
| Any therapy | 145 (75.1) | 245 (82.5) | .048 |
| Ribavirin | 42 (21.8) | 100 (33.7) | .005 |
| Oseltamivir | 101 (52.3) | 144 (48.5) | .405 |
| IVIG | 15 (7.8) | 52 (17.5) | .002 |
| Bronchoscopy | 21 (10.9) | 21 (7.1) | .141 |
| Follow-up duration, d, median (IQR) | 90 (90–90) | 90 (90–90) | .215 |
| 30-d all-cause mortality | 5 (2.6) | 15 (5.1) | .179 |
| 30-d RVI-related mortality | 4 (2.1) | 15 (5.1) | .095 |
| 90-d all-cause mortality | 12 (6.2) | 20 (6.7) | .821 |
| Variablea . | Lymphoma (n = 193) . | Multiple Myeloma (n = 297) . | P Value . |
|---|---|---|---|
| Demographics | |||
| Age at RVI diagnosis, y, mean ± SD | 58.3 ± 17.0 | 64.0 ± 10.7 | <.001 |
| Sex | |||
| Female | 79 (40.9) | 137 (46.1) | .258 |
| Male | 114 (59.1) | 160 (53.9) | |
| Race/ethnicity | |||
| Non-Hispanic White | 126 (65.3) | 151 (50.8) | <.001 |
| Hispanic | 37 (19.2) | 51 (17.2) | |
| Black | 15 (7.8) | 77 (25.9) | |
| Asian | 13 (6.7) | 16 (5.4) | |
| Other | 2 (1.0) | 2 (0.7) | |
| Smoking statusb | |||
| Never | 130 (67.7) | 184 (62.0) | .096 |
| Former | 54 (28.1) | 107 (36.0) | |
| Current | 8 (4.2) | 6 (2.0) | |
| Influenza vaccination (current season) | 30 (15.5) | 100 (33.7) | <.001 |
| HM characteristics | |||
| Active malignancy at RVI diagnosis | 112 (58.0) | 239 (80.5) | <.001 |
| Active antineoplastic treatment at RVI diagnosis | 130 (67.4) | 255 (85.9) | <.001 |
| Steroid use within 30 d of RVI diagnosis (mg prednisone equivalent) | |||
| Any | 80 (41.5) | 216 (72.7) | <.001 |
| 30-d cumulative steroid dosage, median (IQR)c | 500 (160–907) | 533 (267–1066) | .063 |
| Peak dose ≤1 mg/kg/dd (n = 295) | 38 (47.5) | 48 (22.3) | <.001 |
| Peak dose >1 mg/kg/dd | 42 (52.5) | 167 (77.7) | |
| Previous chest radiotherapy | 31 (16.1) | 65 (21.9) | .113 |
| History of HCT | |||
| None | 161 (83.4) | 105 (35.4) | <.001 |
| Autologous | 25 (13.0) | 189 (63.6) | |
| Allogeneic | 7 (3.6) | 3 (1.0) | |
| History of CAR-T therapy | 18 (9.3) | 18 (6.1) | .176 |
| RVI clinical course | |||
| Pathogen | |||
| RSV | 81 (42.0) | 151 (50.9) | .155 |
| Influenza | 111 (57.5) | 145 (48.8) | |
| RSV + influenza | 1 (0.5) | 1 (0.3) | |
| Respiratory viral coinfection (during ±2 wk) | 37 (19.2) | 48 (16.2) | .390 |
| Site of infection at presentation | |||
| URI | 131 (67.9) | 172 (57.9) | .027 |
| LRI | 62 (32.1) | 125 (42.1) | |
| Progression to LRI (among URI)e | 9 (6.9) | 10 (5.8) | .707 |
| Total LRI (presentation and progression) | 71 (36.8) | 135 (45.5) | .058 |
| LRI typef | |||
| Probable | 52 (73.2) | 118 (87.4) | .001 |
| Laboratory confirmed | 19 (26.8) | 17 (12.6) | |
| Year of infection | |||
| 2016 | 13 (6.8) | 32 (10.8) | .029 |
| 2017 | 50 (25.9) | 48 (16.2) | |
| 2018 | 29 (15.0) | 44 (14.8) | |
| 2019 | 51 (26.5) | 64 (21.5) | |
| 2020 | 18 (9.3) | 35 (11.8) | |
| 2021 | 13 (6.7) | 23 (7.7) | |
| 2022 | 19 (9.8) | 51 (17.2) | |
| Time period of infection | |||
| Pre–COVID-19 era (Jan 2016–Mar 2020) | 159 (82.4) | 217 (73.1) | .017 |
| COVID-19 era (Mar 2020–Dec 2022) | 34 (17.6) | 80 (26.9) | |
| RVI symptoms | |||
| Cough | 164 (85.0) | 264 (88.9) | .203 |
| Fever | 97 (50.3) | 153 (51.5) | .786 |
| Shortness of breath | 56 (29.0) | 106 (35.7) | .125 |
| Rhinorrhea | 63 (32.6) | 85 (28.6) | .343 |
| Nasal congestion | 62 (32.1) | 89 (30.0) | .613 |
| Fatigue | 66 (34.2) | 83 (27.9) | .142 |
| Sore throat | 30 (15.5) | 43 (14.5) | .746 |
| Chills | 29 (15.0) | 52 (17.5) | .470 |
| Headache | 22 (11.4) | 32 (10.8) | .829 |
| Nausea/vomiting | 23 (11.9) | 32 (10.8) | .695 |
| Myalgia | 22 (11.4) | 24 (8.1) | .219 |
| Diarrhea | 15 (7.8) | 23 (7.7) | .991 |
| Chest pain | 14 (7.3) | 19 (6.4) | .712 |
| Arthralgia | 7 (3.6) | 7 (2.4) | .410 |
| Hypoxia at presentation (≤92%) in room airg | 17 (9.3)h | 32 (11.4)i | .476 |
| Nosocomial infection | 10 (5.2) | 10 (3.4) | .321 |
| Lymphopenia (<200 cells/mL) | 21 (10.9) | 39 (13.1) | .458 |
| Neutropenia (<500 cells/mL) | 17 (8.8) | 11 (3.7) | .017 |
| Lymphopenia and neutropenia | 8 (4.1) | 9 (3.0) | .510 |
| Elevated creatinine (≥1.2 mg/dL) | 37 (19.2) | 109 (36.7) | <.001 |
| RVI outcomes | |||
| Hospital admission | |||
| Any | 100 (51.8) | 180 (60.6) | .055 |
| Secondary to RVI | 77 (39.9) | 155 (52.2) | .008 |
| Length of stay, d, median (IQR)j | 6 (3–9) | 5 (3–9) | .429 |
| ICU admission | 19 (9.8) | 19 (6.4) | .163 |
| Oxygen requirement (maximal) | |||
| None | 143 (74.1) | 189 (63.6) | .031 |
| Nasal cannula | 27 (14.0) | 71 (23.9) | |
| Face mask | 2 (1.0) | 6 (2.0) | |
| HFNC | 9 (4.7) | 11 (3.7) | |
| BiPAP | 3 (1.6) | 12 (4.0) | |
| Mechanical ventilation | 9 (4.7) | 8 (2.7) | |
| Antiviral timing from symptom onset | |||
| No treatment | 48 (24.9) | 52 (17.5) | .073 |
| Within 48 h | 57 (29.5) | 82 (27.6) | |
| After 48 h | 88 (45.6) | 163 (54.9) | |
| Antiviral therapy | |||
| Any therapy | 145 (75.1) | 245 (82.5) | .048 |
| Ribavirin | 42 (21.8) | 100 (33.7) | .005 |
| Oseltamivir | 101 (52.3) | 144 (48.5) | .405 |
| IVIG | 15 (7.8) | 52 (17.5) | .002 |
| Bronchoscopy | 21 (10.9) | 21 (7.1) | .141 |
| Follow-up duration, d, median (IQR) | 90 (90–90) | 90 (90–90) | .215 |
| 30-d all-cause mortality | 5 (2.6) | 15 (5.1) | .179 |
| 30-d RVI-related mortality | 4 (2.1) | 15 (5.1) | .095 |
| 90-d all-cause mortality | 12 (6.2) | 20 (6.7) | .821 |
P values less than .05 are indicated in bold format.
Abbreviations: BiPAP, bilevel positive airway pressure; CAR-T, chimeric antigen receptor T-cell; COVID-19, coronavirus disease 2019; HCT, hematopoietic stem cell transplantation; HFNC, high-flow nasal cannula; ICU, intensive care unit; IQR, interquartile range; IVIG, intravenous immunoglobulin; LRI, lower respiratory tract infection; RSV, respiratory syncytial virus; RVI, respiratory virus infection; SD, standard deviation; URI, upper respiratory tract infection.
aData are presented as No. (%) unless otherwise specified.
bn = 489.
cn = 294.
dn = 295.
en = 303.
fn = 206.
gn = 462.
hn = 182.
in = 280.
jn = 280.
Baseline Characteristics and Clinical Outcomes Following Viral Infection (Influenza and Respiratory Syncytial Virus), by Baseline Hematological Malignancy
| Variablea . | Lymphoma (n = 193) . | Multiple Myeloma (n = 297) . | P Value . |
|---|---|---|---|
| Demographics | |||
| Age at RVI diagnosis, y, mean ± SD | 58.3 ± 17.0 | 64.0 ± 10.7 | <.001 |
| Sex | |||
| Female | 79 (40.9) | 137 (46.1) | .258 |
| Male | 114 (59.1) | 160 (53.9) | |
| Race/ethnicity | |||
| Non-Hispanic White | 126 (65.3) | 151 (50.8) | <.001 |
| Hispanic | 37 (19.2) | 51 (17.2) | |
| Black | 15 (7.8) | 77 (25.9) | |
| Asian | 13 (6.7) | 16 (5.4) | |
| Other | 2 (1.0) | 2 (0.7) | |
| Smoking statusb | |||
| Never | 130 (67.7) | 184 (62.0) | .096 |
| Former | 54 (28.1) | 107 (36.0) | |
| Current | 8 (4.2) | 6 (2.0) | |
| Influenza vaccination (current season) | 30 (15.5) | 100 (33.7) | <.001 |
| HM characteristics | |||
| Active malignancy at RVI diagnosis | 112 (58.0) | 239 (80.5) | <.001 |
| Active antineoplastic treatment at RVI diagnosis | 130 (67.4) | 255 (85.9) | <.001 |
| Steroid use within 30 d of RVI diagnosis (mg prednisone equivalent) | |||
| Any | 80 (41.5) | 216 (72.7) | <.001 |
| 30-d cumulative steroid dosage, median (IQR)c | 500 (160–907) | 533 (267–1066) | .063 |
| Peak dose ≤1 mg/kg/dd (n = 295) | 38 (47.5) | 48 (22.3) | <.001 |
| Peak dose >1 mg/kg/dd | 42 (52.5) | 167 (77.7) | |
| Previous chest radiotherapy | 31 (16.1) | 65 (21.9) | .113 |
| History of HCT | |||
| None | 161 (83.4) | 105 (35.4) | <.001 |
| Autologous | 25 (13.0) | 189 (63.6) | |
| Allogeneic | 7 (3.6) | 3 (1.0) | |
| History of CAR-T therapy | 18 (9.3) | 18 (6.1) | .176 |
| RVI clinical course | |||
| Pathogen | |||
| RSV | 81 (42.0) | 151 (50.9) | .155 |
| Influenza | 111 (57.5) | 145 (48.8) | |
| RSV + influenza | 1 (0.5) | 1 (0.3) | |
| Respiratory viral coinfection (during ±2 wk) | 37 (19.2) | 48 (16.2) | .390 |
| Site of infection at presentation | |||
| URI | 131 (67.9) | 172 (57.9) | .027 |
| LRI | 62 (32.1) | 125 (42.1) | |
| Progression to LRI (among URI)e | 9 (6.9) | 10 (5.8) | .707 |
| Total LRI (presentation and progression) | 71 (36.8) | 135 (45.5) | .058 |
| LRI typef | |||
| Probable | 52 (73.2) | 118 (87.4) | .001 |
| Laboratory confirmed | 19 (26.8) | 17 (12.6) | |
| Year of infection | |||
| 2016 | 13 (6.8) | 32 (10.8) | .029 |
| 2017 | 50 (25.9) | 48 (16.2) | |
| 2018 | 29 (15.0) | 44 (14.8) | |
| 2019 | 51 (26.5) | 64 (21.5) | |
| 2020 | 18 (9.3) | 35 (11.8) | |
| 2021 | 13 (6.7) | 23 (7.7) | |
| 2022 | 19 (9.8) | 51 (17.2) | |
| Time period of infection | |||
| Pre–COVID-19 era (Jan 2016–Mar 2020) | 159 (82.4) | 217 (73.1) | .017 |
| COVID-19 era (Mar 2020–Dec 2022) | 34 (17.6) | 80 (26.9) | |
| RVI symptoms | |||
| Cough | 164 (85.0) | 264 (88.9) | .203 |
| Fever | 97 (50.3) | 153 (51.5) | .786 |
| Shortness of breath | 56 (29.0) | 106 (35.7) | .125 |
| Rhinorrhea | 63 (32.6) | 85 (28.6) | .343 |
| Nasal congestion | 62 (32.1) | 89 (30.0) | .613 |
| Fatigue | 66 (34.2) | 83 (27.9) | .142 |
| Sore throat | 30 (15.5) | 43 (14.5) | .746 |
| Chills | 29 (15.0) | 52 (17.5) | .470 |
| Headache | 22 (11.4) | 32 (10.8) | .829 |
| Nausea/vomiting | 23 (11.9) | 32 (10.8) | .695 |
| Myalgia | 22 (11.4) | 24 (8.1) | .219 |
| Diarrhea | 15 (7.8) | 23 (7.7) | .991 |
| Chest pain | 14 (7.3) | 19 (6.4) | .712 |
| Arthralgia | 7 (3.6) | 7 (2.4) | .410 |
| Hypoxia at presentation (≤92%) in room airg | 17 (9.3)h | 32 (11.4)i | .476 |
| Nosocomial infection | 10 (5.2) | 10 (3.4) | .321 |
| Lymphopenia (<200 cells/mL) | 21 (10.9) | 39 (13.1) | .458 |
| Neutropenia (<500 cells/mL) | 17 (8.8) | 11 (3.7) | .017 |
| Lymphopenia and neutropenia | 8 (4.1) | 9 (3.0) | .510 |
| Elevated creatinine (≥1.2 mg/dL) | 37 (19.2) | 109 (36.7) | <.001 |
| RVI outcomes | |||
| Hospital admission | |||
| Any | 100 (51.8) | 180 (60.6) | .055 |
| Secondary to RVI | 77 (39.9) | 155 (52.2) | .008 |
| Length of stay, d, median (IQR)j | 6 (3–9) | 5 (3–9) | .429 |
| ICU admission | 19 (9.8) | 19 (6.4) | .163 |
| Oxygen requirement (maximal) | |||
| None | 143 (74.1) | 189 (63.6) | .031 |
| Nasal cannula | 27 (14.0) | 71 (23.9) | |
| Face mask | 2 (1.0) | 6 (2.0) | |
| HFNC | 9 (4.7) | 11 (3.7) | |
| BiPAP | 3 (1.6) | 12 (4.0) | |
| Mechanical ventilation | 9 (4.7) | 8 (2.7) | |
| Antiviral timing from symptom onset | |||
| No treatment | 48 (24.9) | 52 (17.5) | .073 |
| Within 48 h | 57 (29.5) | 82 (27.6) | |
| After 48 h | 88 (45.6) | 163 (54.9) | |
| Antiviral therapy | |||
| Any therapy | 145 (75.1) | 245 (82.5) | .048 |
| Ribavirin | 42 (21.8) | 100 (33.7) | .005 |
| Oseltamivir | 101 (52.3) | 144 (48.5) | .405 |
| IVIG | 15 (7.8) | 52 (17.5) | .002 |
| Bronchoscopy | 21 (10.9) | 21 (7.1) | .141 |
| Follow-up duration, d, median (IQR) | 90 (90–90) | 90 (90–90) | .215 |
| 30-d all-cause mortality | 5 (2.6) | 15 (5.1) | .179 |
| 30-d RVI-related mortality | 4 (2.1) | 15 (5.1) | .095 |
| 90-d all-cause mortality | 12 (6.2) | 20 (6.7) | .821 |
| Variablea . | Lymphoma (n = 193) . | Multiple Myeloma (n = 297) . | P Value . |
|---|---|---|---|
| Demographics | |||
| Age at RVI diagnosis, y, mean ± SD | 58.3 ± 17.0 | 64.0 ± 10.7 | <.001 |
| Sex | |||
| Female | 79 (40.9) | 137 (46.1) | .258 |
| Male | 114 (59.1) | 160 (53.9) | |
| Race/ethnicity | |||
| Non-Hispanic White | 126 (65.3) | 151 (50.8) | <.001 |
| Hispanic | 37 (19.2) | 51 (17.2) | |
| Black | 15 (7.8) | 77 (25.9) | |
| Asian | 13 (6.7) | 16 (5.4) | |
| Other | 2 (1.0) | 2 (0.7) | |
| Smoking statusb | |||
| Never | 130 (67.7) | 184 (62.0) | .096 |
| Former | 54 (28.1) | 107 (36.0) | |
| Current | 8 (4.2) | 6 (2.0) | |
| Influenza vaccination (current season) | 30 (15.5) | 100 (33.7) | <.001 |
| HM characteristics | |||
| Active malignancy at RVI diagnosis | 112 (58.0) | 239 (80.5) | <.001 |
| Active antineoplastic treatment at RVI diagnosis | 130 (67.4) | 255 (85.9) | <.001 |
| Steroid use within 30 d of RVI diagnosis (mg prednisone equivalent) | |||
| Any | 80 (41.5) | 216 (72.7) | <.001 |
| 30-d cumulative steroid dosage, median (IQR)c | 500 (160–907) | 533 (267–1066) | .063 |
| Peak dose ≤1 mg/kg/dd (n = 295) | 38 (47.5) | 48 (22.3) | <.001 |
| Peak dose >1 mg/kg/dd | 42 (52.5) | 167 (77.7) | |
| Previous chest radiotherapy | 31 (16.1) | 65 (21.9) | .113 |
| History of HCT | |||
| None | 161 (83.4) | 105 (35.4) | <.001 |
| Autologous | 25 (13.0) | 189 (63.6) | |
| Allogeneic | 7 (3.6) | 3 (1.0) | |
| History of CAR-T therapy | 18 (9.3) | 18 (6.1) | .176 |
| RVI clinical course | |||
| Pathogen | |||
| RSV | 81 (42.0) | 151 (50.9) | .155 |
| Influenza | 111 (57.5) | 145 (48.8) | |
| RSV + influenza | 1 (0.5) | 1 (0.3) | |
| Respiratory viral coinfection (during ±2 wk) | 37 (19.2) | 48 (16.2) | .390 |
| Site of infection at presentation | |||
| URI | 131 (67.9) | 172 (57.9) | .027 |
| LRI | 62 (32.1) | 125 (42.1) | |
| Progression to LRI (among URI)e | 9 (6.9) | 10 (5.8) | .707 |
| Total LRI (presentation and progression) | 71 (36.8) | 135 (45.5) | .058 |
| LRI typef | |||
| Probable | 52 (73.2) | 118 (87.4) | .001 |
| Laboratory confirmed | 19 (26.8) | 17 (12.6) | |
| Year of infection | |||
| 2016 | 13 (6.8) | 32 (10.8) | .029 |
| 2017 | 50 (25.9) | 48 (16.2) | |
| 2018 | 29 (15.0) | 44 (14.8) | |
| 2019 | 51 (26.5) | 64 (21.5) | |
| 2020 | 18 (9.3) | 35 (11.8) | |
| 2021 | 13 (6.7) | 23 (7.7) | |
| 2022 | 19 (9.8) | 51 (17.2) | |
| Time period of infection | |||
| Pre–COVID-19 era (Jan 2016–Mar 2020) | 159 (82.4) | 217 (73.1) | .017 |
| COVID-19 era (Mar 2020–Dec 2022) | 34 (17.6) | 80 (26.9) | |
| RVI symptoms | |||
| Cough | 164 (85.0) | 264 (88.9) | .203 |
| Fever | 97 (50.3) | 153 (51.5) | .786 |
| Shortness of breath | 56 (29.0) | 106 (35.7) | .125 |
| Rhinorrhea | 63 (32.6) | 85 (28.6) | .343 |
| Nasal congestion | 62 (32.1) | 89 (30.0) | .613 |
| Fatigue | 66 (34.2) | 83 (27.9) | .142 |
| Sore throat | 30 (15.5) | 43 (14.5) | .746 |
| Chills | 29 (15.0) | 52 (17.5) | .470 |
| Headache | 22 (11.4) | 32 (10.8) | .829 |
| Nausea/vomiting | 23 (11.9) | 32 (10.8) | .695 |
| Myalgia | 22 (11.4) | 24 (8.1) | .219 |
| Diarrhea | 15 (7.8) | 23 (7.7) | .991 |
| Chest pain | 14 (7.3) | 19 (6.4) | .712 |
| Arthralgia | 7 (3.6) | 7 (2.4) | .410 |
| Hypoxia at presentation (≤92%) in room airg | 17 (9.3)h | 32 (11.4)i | .476 |
| Nosocomial infection | 10 (5.2) | 10 (3.4) | .321 |
| Lymphopenia (<200 cells/mL) | 21 (10.9) | 39 (13.1) | .458 |
| Neutropenia (<500 cells/mL) | 17 (8.8) | 11 (3.7) | .017 |
| Lymphopenia and neutropenia | 8 (4.1) | 9 (3.0) | .510 |
| Elevated creatinine (≥1.2 mg/dL) | 37 (19.2) | 109 (36.7) | <.001 |
| RVI outcomes | |||
| Hospital admission | |||
| Any | 100 (51.8) | 180 (60.6) | .055 |
| Secondary to RVI | 77 (39.9) | 155 (52.2) | .008 |
| Length of stay, d, median (IQR)j | 6 (3–9) | 5 (3–9) | .429 |
| ICU admission | 19 (9.8) | 19 (6.4) | .163 |
| Oxygen requirement (maximal) | |||
| None | 143 (74.1) | 189 (63.6) | .031 |
| Nasal cannula | 27 (14.0) | 71 (23.9) | |
| Face mask | 2 (1.0) | 6 (2.0) | |
| HFNC | 9 (4.7) | 11 (3.7) | |
| BiPAP | 3 (1.6) | 12 (4.0) | |
| Mechanical ventilation | 9 (4.7) | 8 (2.7) | |
| Antiviral timing from symptom onset | |||
| No treatment | 48 (24.9) | 52 (17.5) | .073 |
| Within 48 h | 57 (29.5) | 82 (27.6) | |
| After 48 h | 88 (45.6) | 163 (54.9) | |
| Antiviral therapy | |||
| Any therapy | 145 (75.1) | 245 (82.5) | .048 |
| Ribavirin | 42 (21.8) | 100 (33.7) | .005 |
| Oseltamivir | 101 (52.3) | 144 (48.5) | .405 |
| IVIG | 15 (7.8) | 52 (17.5) | .002 |
| Bronchoscopy | 21 (10.9) | 21 (7.1) | .141 |
| Follow-up duration, d, median (IQR) | 90 (90–90) | 90 (90–90) | .215 |
| 30-d all-cause mortality | 5 (2.6) | 15 (5.1) | .179 |
| 30-d RVI-related mortality | 4 (2.1) | 15 (5.1) | .095 |
| 90-d all-cause mortality | 12 (6.2) | 20 (6.7) | .821 |
P values less than .05 are indicated in bold format.
Abbreviations: BiPAP, bilevel positive airway pressure; CAR-T, chimeric antigen receptor T-cell; COVID-19, coronavirus disease 2019; HCT, hematopoietic stem cell transplantation; HFNC, high-flow nasal cannula; ICU, intensive care unit; IQR, interquartile range; IVIG, intravenous immunoglobulin; LRI, lower respiratory tract infection; RSV, respiratory syncytial virus; RVI, respiratory virus infection; SD, standard deviation; URI, upper respiratory tract infection.
aData are presented as No. (%) unless otherwise specified.
bn = 489.
cn = 294.
dn = 295.
en = 303.
fn = 206.
gn = 462.
hn = 182.
in = 280.
jn = 280.
This PDF is available to Subscribers Only
View Article Abstract & Purchase OptionsFor full access to this pdf, sign in to an existing account, or purchase an annual subscription.
