The Burden of Community-acquired Respiratory Viral Infections in High-risk Immunocompromised Patients After the COVID-19 Pandemic
Notice bibliographique
Résumé
Abstract Rationale The COVID-19 pandemic and subsequent public health measures significantly altered the landscape of community-acquired respiratory viral infections (CARVs). Those experiencing immunosuppression from treatment of hematologic malignancies, including hematopoietic cell transplantation (HCT), are particularly susceptible to poor outcomes. Our study sought to better understand the incidence and clinical impact of CARVs in these immunocompromised individuals in the year immediately following the COVID-19 pandemic. Methods This prospective, multicenter, observational study was conducted at four large academic centers from January 2023 to March 2024. Eligibility criteria included adults (>18 years of age) with active hematological malignancies and after HCT. Participants were followed every 2 weeks for respiratory symptoms using a cloud-based symptom tracker for up to 12 months. Following a positive acute respiratory infection (ARI) symptom screen, in person evaluations were conducted which included physical examination, laboratory tests, and a nasal swab for polymerase chain reaction (PCR) testing for 18 viral and 4 bacterial pathogens with a commercially available assay (BioFire). Results A total of 140 participants were enrolled and 80% completed the study. The most common reasons for study discontinuation was death (20%, 12/28), and subject withdrawl (6.4%, 9/28). The median age of participants was 60 years and 75 (53.6%) were female. Participants were non-Hispanic, caucasian (72.1%), Asian (14%) and black (10.3%). The majority had received an HCT (83.6%, n=117); median time between transplantation and enrollment was 1 year. At least once before or during the study, 99 (71%) participants received a COVID-19 vaccine, and 32 (22.9%) participants received an Influenza vaccine. The symptom tracker triggered 100 ARI visits in 64 participants, of which 60 (43%, 60/140) had clinically confirmed infection with 87% of confirmed cases having a positive respiratory viral PCR panel. The incidence rate of clinically confirmed ARIs was 5.01 per 100 participant months (95% CI: 3.86-6.41). The most common CARV was rhinovirus/enterovirus (n=14, 23.3%) followed by COVID-19 (n=13, 21.7%) and seasonal coronavirus (n=5, 8.3%) (Figure 1). There were no confirmed bacterial infections. Hospitalization occurred in 8 participants (13.3%), with 4 requiring intensive care unit admission. In total, 12 deaths occurred; 3 followed a clinically confirmed ARI including one attributed to respiratory failure. Conclusions This study underscores the significant burden of CARVs in immunocompromised individuals, particularly those post-HCT. The findings highlight the need for robust public health strategies, improved vaccination efforts, and research into effective diagnostic and therapeutic interventions to mitigate the risks faced by this vulnerable population.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».