Are any specific respiratory viruses more severe than others in recipients of allogeneic stem cell transplantation? A focus on lower respiratory tract disease.

Autores de IIS La Fe

• David Gómez Peregrina

  Autor

• Juan Bautista Montoro Gómez

  Autor

• Pedro Miguel Aparicio Chorao

  Autor

• Manuel Nuno Direito De Morais Guerreiro

  Autor

• Marta Villalba Montaner

  Autor

Participantes ajenos a IIS La Fe

• Pérez A
• Hernani R
• Albert E
• Carbonell-Asins JA
• Hernández-Boluda JC
• Navarro D
• Solano C
• Piñana JL

Grupos

• Hematología y Hemoterapia

  

  Investigador Principal

  Javier De La Rubia Comos

Abstract

In the general population, influenza virus, respiratory syncytial virus, and SARS-CoV-2 are considered the most severe community-acquired respiratory viruses (CARVs). However, allogeneic stem cell transplant (allo-SCT) recipients may also face severe courses from other CARVs. This retrospective study compared outcomes of various CARV lower respiratory tract diseases (LRTD) in 235 adult allo-SCT recipients, excluding co-infection episodes. We included 235 adults allo-SCT recipients experiencing 353 CARV LRTD consecutive episodes (130 rhinovirus, 63 respiratory syncytial virus, 43 influenza, 43 human parainfluenza virus, 23 human metapneumovirus, 19 Omicron SARS-CoV-2, 17 common coronavirus, 10 adenovirus and 5 human bocavirus) between December 2013 and June 2023. Day 100 overall survival ranged from 78% to 90% without significant differences among CARV types. Multivariable analysis of day 100 all-cause mortality identified corticosteroid use of >1 to <30 mg/d [Hazard ratio (HR) 2.45, p = 0.02) and =30 mg/d (HR 2.20, p = 0.015) along with absolute lymphocyte count <0.2 × 10(9)/L (HR 5.82, p < 0.001) and number of CARV episodes as a continuous variable per one episode increase (HR 0.48, p = 0.001) as independent risk factors for all-cause mortality. Degree of immunosuppression, rather than intrinsic CARV virulence, has the most significant impact on mortality in allo-SCT recipients with CARV-LRTD.

© 2024. The Author(s), under exclusive licence to Springer Nature Limited.

Keywords

• INFECTIONS; ASSOCIATION; OUTCOMES