P-2272. The CARV challenge: How do hematological malignancy patients struggle with diverse CARV pathogens
Authors: Salmanton-Garcia Jon , Marchesi Francesco , Labrador Jorge , Fracchiolla Nicola , Bilgin Yavuz M , Del Principe Maria Ilaria , Drgoňa Ľuboš , Rahimli Laman , Plantefève Gaëtan , Van Praet Jens , Sgherza Nicola , Piukovics Klara , Espigado Ildefonso , Fernando Inmaculada Heras , Cornely Oliver A , Pagano Livio 
Published: January 2025

Abstract

Background
With growing concerns about the effects of community-acquired respiratory viruses (CARVs) on hematological malignancy patients, proactive measures are necessary to minimize risks and improve treatment results. This study aimed to collect and analyze epidemiological, management, and outcome data from these patients with CARV infections to develop customized clinical management approaches.Table 1.Patient characterisitics

Methods
Utilizing an online registry, data from of CARV infections in hematological malignancy patients were collected from January 2023 to January 2024, spanning 53 sites across 21 countries.

Results
Our survey included 561 cases of CARV in hematological malignancy patients, with a majority from Italy (39%) and Spain (19%). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) made up 63% of cases, followed by influenza (15%), respiratory syncytial virus (12%), and rhinovirus (9%). The distribution of CARVs mirrored the overall prevalence across different malignancies, with 27% in acute leukemias and non-Hodgkin lymphoma each, and 21% in multiple myeloma. Stem cell transplantation or CAR-T therapy preceded CARV infection in 24% of patients, particularly with metapneumovirus (67%) and parainfluenza (60%). Chronic cardiopathies were the most common comorbidity (41%). Critical illness was more prevalent in metapneumovirus (22%) and influenza cases (18%) compared to RSV (11%) or SARS-CoV-2 (8%). Metapneumovirus and parainfluenza had the highest mortality rates (33% and 30%, respectively), surpassing those of influenza (16%) or SARS-CoV-2 (11%). SARS-CoV-2 (68%) and RSV (50%) had the highest associated mortality rates. Progression of baseline malignancy contributed to 50% of overall mortalities. Further details are provided in Table 1.

Conclusion
Our study underscores the significant impact of CARV on hematological malignancy patients, especially with SARS-CoV-2 predominance. The distribution of CARVs reflected malignancy prevalence, with acute leukemias and non-Hodgkin lymphoma most affected. Moreover, we found heightened severity and mortality rates associated with specific CARV pathogens such as metapneumovirus and parainfluenza.

Disclosures
Oliver A. Cornely, Prof. Dr., Abbott: Honoraria|Abbvie: Advisor/Consultant|Abbvie: Honoraria|AiCuris: Advisor/Consultant|Akademie fur Infektionmedizin: Honoraria|Al-Jazeera Pharmaceuticals/Hikma: Honoraria|amedes: Honoraria|AstraZeneca: Honoraria|Basilea: Advisor/Consultant|Biocon: Advisor/Consultant|BMBF: Grant/Research Support|Boston Strategic Partners: Advisor/Consultant|CIdara: Advisor/Consultant|CIdara: Expert Testimony|CIdara: Grant/Research Support|CIdara: Participation on a DRC or DSMB|CoRe Consulting: Stocks/Bonds (Private Company)|Deutscher Arzteverlag: Honoraria|DZIF: Grant/Research Support|EasyRadiology: Stocks/Bonds (Private Company)|EU-DG RTD: Grant/Research Support|F2G: Grant/Research Support|Gilead: Advisor/Consultant|Gilead: Grant/Research Support|Gilead: Honoraria|Grupo Biotoscana/United Medical/Knight: Honoraria|GSK: Advisor/Consultant|GSK: Honoraria|IQVIA: Advisor/Consultant|IQVIA: Participation on a DRC or DSMB|Janssen: Advisor/Consultant|Janssen: Participation on a DRC or DSMB|Matinas: Advisor/Consultant|MedPace: Advisor/Consultant|MedPace: Grant/Research Support|MedPace: Participation on a DRC or DSMB|Medscape/WebMD: Honoraria|MedUpdate: Honoraria|Menarini: Advisor/Consultant|Moderna: Honoraria|Molecular Partners: Advisor/Consultant|MSD: Grant/Research Support|MSD: Honoraria|MSG-ERC: Advisor/Consultant|Mundipharma: Advisor/Consultant|Mundipharma: Grant/Research Support|Mundipharma: Honoraria|Noscendo: Honoraria|Noxxon: Advisor/Consultant|Octapharma: Advisor/Consultant|Octapharma: Grant/Research Support|Pardes: Advisor/Consultant|Partner Therapeutics: Advisor/Consultant|Patent: US18/562644|Paul-Martini-Stiftung: Honoraria|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Pfizer: Honoraria|PSI: Advisor/Consultant|PSI: Participation on a DRC or DSMB|Pulmocide: Participation on a DRC or DSMB|Sandoz: Honoraria|Scynexis: Advisor/Consultant|Scynexis: Grant/Research Support|Seqirus: Advisor/Consultant|Seqirus: Honoraria|Seres: Advisor/Consultant|Shionogi: Advisor/Consultant|Shionogi: Honoraria|streamedup!: Honoraria|The Prime Meridian Group: Advisor/Consultant|Touch Independent: Honoraria|Vitis: Honoraria