Severe Morbidity and Mortality Associated With Respiratory Syncytial Virus Versus Influenza Infection in Hospitalized Older Adults.
adult
hospitalization
influenza
mortality
respiratory syncytial virus
Journal
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213
Informations de publication
Date de publication:
02 07 2019
02 07 2019
Historique:
received:
06
08
2018
accepted:
15
11
2018
pubmed:
20
11
2018
medline:
31
7
2020
entrez:
20
11
2018
Statut:
ppublish
Résumé
Respiratory syncytial virus (RSV) is an important cause of serious respiratory illness in older adults. Comparison of RSV and influenza infection in hospitalized older adults may increase awareness of adult RSV disease burden. Hospitalized adults aged ≥60 years who tested positive for RSV or influenza between 1 January 2011 and 30 June 2015 were identified from Kaiser Permanente Southern California electronic medical records. Baseline characteristics, comorbidities, utilization, and outcomes were compared. The study included 645 RSV- and 1878 influenza-infected hospitalized adults. Patients with RSV were older than those with influenza (mean, 78.5 vs 77.4 years; P = .035) and more likely to have congestive heart failure (35.3% vs 24.5%; P < .001) and chronic obstructive pulmonary disease (COPD) (29.8% vs 24.3%; P = .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 < .001); pneumonia (OR = 2.7; 95% CI, 2.2-3.2; P < .001); intensive care unit admission (OR = 1.3; 95% CI, 1.0-1.7; P = .023); exacerbation of COPD (OR = 1.7; 95% CI, 1.3-2.4; P = .001); and greater mortality within 1 year of admission (OR = 1.3; 95% CI, 1.0-1.6; P = .019). RSV infection may result in greater morbidity and mortality among older hospitalized adults than influenza. Increased recognition of adult RSV disease burden will be important in the evaluation and use of new RSV vaccines and antivirals.
Sections du résumé
BACKGROUND
Respiratory syncytial virus (RSV) is an important cause of serious respiratory illness in older adults. Comparison of RSV and influenza infection in hospitalized older adults may increase awareness of adult RSV disease burden.
METHODS
Hospitalized adults aged ≥60 years who tested positive for RSV or influenza between 1 January 2011 and 30 June 2015 were identified from Kaiser Permanente Southern California electronic medical records. Baseline characteristics, comorbidities, utilization, and outcomes were compared.
RESULTS
The study included 645 RSV- and 1878 influenza-infected hospitalized adults. Patients with RSV were older than those with influenza (mean, 78.5 vs 77.4 years; P = .035) and more likely to have congestive heart failure (35.3% vs 24.5%; P < .001) and chronic obstructive pulmonary disease (COPD) (29.8% vs 24.3%; P = .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 < .001); pneumonia (OR = 2.7; 95% CI, 2.2-3.2; P < .001); intensive care unit admission (OR = 1.3; 95% CI, 1.0-1.7; P = .023); exacerbation of COPD (OR = 1.7; 95% CI, 1.3-2.4; P = .001); and greater mortality within 1 year of admission (OR = 1.3; 95% CI, 1.0-1.6; P = .019).
CONCLUSIONS
RSV infection may result in greater morbidity and mortality among older hospitalized adults than influenza. Increased recognition of adult RSV disease burden will be important in the evaluation and use of new RSV vaccines and antivirals.
Identifiants
pubmed: 30452608
pii: 5193205
doi: 10.1093/cid/ciy991
pmc: PMC6603263
doi:
Types de publication
Comparative Study
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
197-203Commentaires et corrections
Type : CommentIn
Type : CommentIn
Type : CommentIn
Informations de copyright
© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America.
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