Epidemiological study on respiratory tract infections in patients with acute leukemia in single center in Beijing, 2018-2024
10.3760/cma.j.cn112309-20250411-00114
- VernacularTitle:2018—2024年北京单中心急性白血病患者呼吸道感染的流行病学研究
- Author:
Jiecheng ZHANG
1
;
Jianwei WANG
Author Information
1. 中国医学科学院/北京协和医学院群医学及公共卫生学院，北京 100730
- Publication Type:Journal Article
- Keywords:
Acute leukemia;
Respiratory pathogens;
COVID-19
- From:
Chinese Journal of Microbiology and Immunology
2025;45(9):717-726
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To retrospectively analyze the epidemiological characteristics of respiratory tract infections in acute leukemia patients in Beijing, and explore the impact of COVID-19 prevalence, leukemia subtypes, and seasonal factors on the detection rate of respiratory pathogens.Methods:This study enrolled 9 700 acute leukemia patients in Beijing GoBroad Boren Hospital before the COVID-19 epidemic (April 2018 to December 2019), during the epidemic (January 2020 to December 2022), and after the epidemic (January 2023 to September 2024), and collected clinical data of these patients and test results for 10 respiratory pathogens. Statistical analysis was performed using t-test, one-way analysis of variance, Wilcoxon test or Kruskal-Wallis test, and Chi-square test or Fisher′s exact test. Results:The overall detection rate of respiratory pathogens in patients with acute leukemia was 5.87% (569/9 700), with Mycoplasma pneumoniae (5.87%, 20/341), parainfluenza virus (5.72%, 47/822), and respiratory syncytial virus (4.89%, 43/879) in the top three. No significant difference in the detection rates was found between male and female patients ( P>0.05), but age-stratified analysis demonstrated significant difference ( P<0.001), with middle-aged adults (35-59 years) exhibiting the highest detection rate (7.98%, 120/1 504) and children (0-17 years) showing the lowest rate (4.94%, 278/5 631). The detection rate of respiratory pathogens in patients with acute leukemia was 21.15% (22/104) before the COVID-19 outbreak, decreased to 2.00% (129/6 450) during the outbreak ( P<0.001), and rebounded to 13.29% (418/3 146) after the outbreak, but was still lower than the pre-epidemic level ( P>0.05). Compared with acute lymphoblastic leukemia (ALL) patients, acute myeloid leukemia (AML) patients had a higher risk of respiratory pathogen infections [8.33% (156/1 873) vs 5.30% (407/7 679), P<0.001], and were more susceptible to infections with SARS-CoV-2 and respiratory syncytial virus. Especially after the epidemic, the detection rate of SARS-CoV-2 was significantly higher in AML patients than in ALL patients [15.14% (68/449) vs 9.98% (224/2 245), P=0.002]. Furthermore, the detection rate of respiratory pathogens showed significant seasonal variations, with the highest detection rate in winter (11.57%, 342/2 955), the second highest in spring (4.31%, 88/2 041), and lower in summer and fall [3.38% (84/2 485), 2.48% (55/2 219)]. Conclusions:The detection rate of respiratory pathogens in acute leukemia patients is significantly affected by age, leukemia subtypes, and season, and the COVID-19 pandemic has significantly altered the epidemiological pattern of respiratory pathogens. AML patients are at high risk for respiratory infections, especially in the wake of the COVID-19 epidemic. These findings provide essential evidence for the prevention and management of respiratory infections in patients with acute leukemia.
