Hospital‐Acquired Respiratory Viral Infections (HA‐RVIs) Over 10 Years Disproportionally Affect the Immunocompromised

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INTRODUCTION: Respiratory viral infections (RVIs) such as influenza (Flu), respiratory syncytial virus (RSV), and parainfluenza (PIV) are associated with increased morbidity and mortality among immunocompromised patients. METHODS: A community-acquired (CA)-Flu/RSV/PIV case was defined as a positive laboratory result collected < 72 h after inpatient admission, whereas an HA-Flu/RSV/PIV case was defined as a positive result collected ≥ 72 h after inpatient admission. RESULTS: During the study period, 6.6% of Flu cases, 12.2% of RSV cases, and 10.9% of PIV cases were HA. Patients with a cancer diagnosis were more prevalent in the HA-Flu (24.3% vs. 11.8%) and HA-RSV (26.7% vs. 11.9%) groups compared to their CA counterparts. Patients who received chemotherapy within the past 30 days were more prevalent in the HA-Flu (10.8% vs. 4.4%), HA-RSV (20.0% vs. 8.1%), and HA-PIV (4.2% vs. 0.7%) groups compared to their CA counterparts. Recipients of SCT within the last year were more prevalent in the HA-Flu (6.3% vs. 2.3%) and HA-RSV (10.7% vs. 3.7%) groups compared to their CA counterparts. In the overall cohort, HA-Flu, HA-RSV, and HA-PIV were all associated with a higher likelihood of ICU admission. HA-Flu was additionally associated with a higher risk of mechanical ventilation, renal replacement therapy, and death compared to CA-Flu. DISCUSSION: Immunocompromised patients are heavily represented among HA cases, pointing to a need for targeted infection prevention and control interventions for vulnerable patient populations during periods of high RVI community transmission.

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