BACKGROUND There is a lack of studies comparing clinical outcomes among retrospective versus prospective cohorts of allogeneic stem cell transplant (allo-HCT) recipients with community acquired respiratory virus (CARV) infections. METHODS We compare outcomes in two consecutive cohorts of allo-HCT recipients with CARV infections. The retrospective cohort included 63 allo-HCT recipients with 108 CARV infections from January 2013 to April 2016 who were screened and managed following standard clinical practice based on influenza and respiratory syncytial virus rapid antigen detection methods. The prospective cohort was comprised of 144 consecutive recipients with 297 CARV episodes included in a prospective interventional clinical surveillance program (ProClinCarvSur-P) based on syndromic multiplex PCR as first-line test from May 2016 to December 2018 at a single transplant center. RESULTS CARV infections in the retrospective cohort showed more severe clinical features at the time of diagnosis compared to the prospective cohort (fever 83% vs. 57%, hospital admission 69% vs. 28% and lower respiratory tract 58% vs. 31%, respectively, p ≤ 0.002 for all comparisons). Antiviral therapy was more commonly prescribed in the prospective cohort (69 vs. 43 treated CARV episodes), particularly at the upper respiratory tract disease stage (34 vs. 12 treated CARV episodes). Three-month all-cause mortality was significantly higher in the retrospective cohort (n = 23, 37% vs. n = 10, 7%, p < 0.0001). Multivariate logistic regression analysis showed that recipients included in ProClinCarvSur-P had lower mortality rate [odds ratio 0.31, 95% confidence interval 0.12-0.7, p = 0.01]. CONCLUSION This study report on outcome differences when reporting retrospective vs. prospective CARV infections after allo-HCT. Recipients included in a ProClinCarvSur-P had lower mortality.

中文翻译：

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在同种异体造血干细胞移植中建立前瞻性临床社区获得的呼吸道病毒监视程序的临床益处。

背景技术目前尚无研究比较同种异体干细胞移植（allo-HCT）接受者与社区获得性呼吸道病毒（CARV）感染的回顾性和前瞻性队列之间的临床结局。方法我们比较了两个连续的同种HCT接受CARV感染者的结局。回顾性队列研究包括2013年1月至2016年4月的63名异种HCT接受者，共108例CARV感染，根据流感和呼吸道合胞病毒快速抗原检测方法，按照标准临床实践进行筛查和管理。前瞻性队列由2016年5月至2018年12月在单一移植中心进行的基于综合多重PCR的前瞻性干预性临床监测计划（ProClinCarvSur-P）中包括144位连续接受者的297 CARV发作。结果与回顾性队列相比，回顾性队列的CARV感染在诊断时显示出更严重的临床特征（发烧83％vs. 57％，入院69％vs. 28％，下呼吸道58％vs. 31％，对于所有比较，p分别为p≤0.002）。在前瞻性队列中，抗病毒治疗更为普遍（69比43治疗CARV发作），尤其是在上呼吸道疾病阶段（34比12治疗CARV发作）。在回顾性队列中，三个月的全因死亡率显着更高（n = 23，37％vs. n = 10，7％，p <0.0001）。多元logistic回归分析显示，ProClinCarvSur-P中包含的接受者死亡率较低[几率0.31，95％置信区间0.12-0.7，p = 0.01]。结论本研究报告了异源HCT报道回顾性和前瞻性CARV感染时的结局差异。ProClinCarvSur-P中包含的收件人死亡率较低。异基因HCT后的前瞻性CARV感染。ProClinCarvSur-P中包含的收件人死亡率较低。异基因HCT后的前瞻性CARV感染。ProClinCarvSur-P中包含的收件人死亡率较低。