tetano
Editor, Senior Moderator
Clin Infect Dis. 2018 Nov 19. doi: 10.1093/cid/ciy991. [Epub ahead of print]
[h=1]Severe Morbidity and Mortality Associated With Respiratory Syncytial Virus Versus Influenza Infection in Hospitalized Older Adults.[/h] Ackerson B[SUP]1[/SUP], Tseng HF[SUP]1[/SUP], Sy LS[SUP]1[/SUP], Solano Z[SUP]1[/SUP], Slezak J[SUP]1[/SUP], Luo Y[SUP]1[/SUP], Fischetti CA[SUP]1[/SUP], Shinde V[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] Respiratory syncytial virus (RSV) is an important but under-recognized cause of serious respiratory illness in adults. Recent comparative data on RSV and influenza infection in hospitalized adults may increase awareness of RSV disease burden in adults.
[h=4]Methods:[/h] Hospitalized adults ≥60 years old testing positive for RSV or influenza by multiplex RT-PCR or viral culture between 01/01/2011 and 06/30/2015 were identified from Kaiser Permanente Southern California electronic medical records. Baseline characteristics, comorbidities, utilization, and outcomes were compared between patients with RSV and influenza infection.
[h=4]Results:[/h] The study included 645 RSV- and 1878 influenza-infected hospitalized adults with most infections detected by multiplex PCR (RSV=92%, influenza=83%). Patients with RSV were slightly older than those with influenza (mean: 78.5 versus 77.4 years; p=0.035), and more likely to have congestive heart failure (35.3% versus 24.5%; p<0.001) and chronic obstructive pulmonary disease (COPD), chronic bronchitis, or emphysema (29.8% versus 24.3%; p=0.006) at baseline. In adjusted analyses, RSV infection was associated with greater odds of length of stay ≥7 days (odds ratio [OR]=1.5; 95% confidence interval [CI]: 1.2-1.8, p<0.001), pneumonia (OR=2.7; 95%CI: 2.2-3.2, p<0.001), intensive care unit admission (OR=1.3; 95%CI: 1.0-1.7, p=0.023), exacerbation of COPD, chronic bronchitis, or emphysema (OR=1.7; 95%CI: 1.3-2.4, p=0.001), and greater mortality within one year of admission (OR=1.3; 95%CI: 1.0-1.6, p=0.019).
[h=4]Conclusion:[/h] RSV infection may result in greater morbidity and mortality among older hospitalized adults than influenza. Increased recognition of RSV disease burden in adults will be important to the evaluation and use of RSV vaccines and antivirals after their introduction.
PMID: 30452608 DOI: 10.1093/cid/ciy991
[h=1]Severe Morbidity and Mortality Associated With Respiratory Syncytial Virus Versus Influenza Infection in Hospitalized Older Adults.[/h] Ackerson B[SUP]1[/SUP], Tseng HF[SUP]1[/SUP], Sy LS[SUP]1[/SUP], Solano Z[SUP]1[/SUP], Slezak J[SUP]1[/SUP], Luo Y[SUP]1[/SUP], Fischetti CA[SUP]1[/SUP], Shinde V[SUP]2[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]Background:[/h] Respiratory syncytial virus (RSV) is an important but under-recognized cause of serious respiratory illness in adults. Recent comparative data on RSV and influenza infection in hospitalized adults may increase awareness of RSV disease burden in adults.
[h=4]Methods:[/h] Hospitalized adults ≥60 years old testing positive for RSV or influenza by multiplex RT-PCR or viral culture between 01/01/2011 and 06/30/2015 were identified from Kaiser Permanente Southern California electronic medical records. Baseline characteristics, comorbidities, utilization, and outcomes were compared between patients with RSV and influenza infection.
[h=4]Results:[/h] The study included 645 RSV- and 1878 influenza-infected hospitalized adults with most infections detected by multiplex PCR (RSV=92%, influenza=83%). Patients with RSV were slightly older than those with influenza (mean: 78.5 versus 77.4 years; p=0.035), and more likely to have congestive heart failure (35.3% versus 24.5%; p<0.001) and chronic obstructive pulmonary disease (COPD), chronic bronchitis, or emphysema (29.8% versus 24.3%; p=0.006) at baseline. In adjusted analyses, RSV infection was associated with greater odds of length of stay ≥7 days (odds ratio [OR]=1.5; 95% confidence interval [CI]: 1.2-1.8, p<0.001), pneumonia (OR=2.7; 95%CI: 2.2-3.2, p<0.001), intensive care unit admission (OR=1.3; 95%CI: 1.0-1.7, p=0.023), exacerbation of COPD, chronic bronchitis, or emphysema (OR=1.7; 95%CI: 1.3-2.4, p=0.001), and greater mortality within one year of admission (OR=1.3; 95%CI: 1.0-1.6, p=0.019).
[h=4]Conclusion:[/h] RSV infection may result in greater morbidity and mortality among older hospitalized adults than influenza. Increased recognition of RSV disease burden in adults will be important to the evaluation and use of RSV vaccines and antivirals after their introduction.
PMID: 30452608 DOI: 10.1093/cid/ciy991