Adult patients with severe respiratory syncytial virus infections in the emergency department.
Humans
Respiratory Syncytial Virus Infections
/ therapy
Male
Female
Emergency Service, Hospital
/ statistics & numerical data
Middle Aged
Adult
Aged
Risk Factors
Length of Stay
/ statistics & numerical data
Severity of Illness Index
Hospitalization
/ statistics & numerical data
Retrospective Studies
SARS-CoV-2
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
27 Sep 2024
27 Sep 2024
Historique:
medline:
27
9
2024
pubmed:
27
9
2024
entrez:
27
9
2024
Statut:
ppublish
Résumé
Respiratory syncytial virus (RSV) is a seasonal virus known to cause significant morbidity in pediatric patients; however, morbidity in adult patients has not been well investigated. We aimed to characterize adult patients with RSV infection in the emergency department (ED) and their clinical course. During the winter term 2022/23, all adult ED patients were screened for RSV, severe acute respiratory syndrome coronavirus type 2, and influenza infection using point-of-care polymerase chain reaction tests. All symptomatic RSV+ patients were further characterized based on their clinical presentation and course. A group comparison between RSV+ inpatients and RSV+ outpatients was conducted. The potential risk factors for inpatient treatment were evaluated using univariate and multivariate analyses. Of the 135 symptomatic RSV+ patients, 51.9% (70/135) were inpatients. Their length of stay were 9.4 (±10.4) days. Inpatients had a significantly higher mean age, lower oxygen saturation, higher leukocyte count, and higher C-reactive protein levels than outpatients. Among the preconditions, pulmonary diseases, tumors, and immunosuppression were significantly more frequent in the inpatient group. Thirty percent (21/70) of the inpatients required ICU treatment, 11% (8/70) required mechanical ventilation, and 9% (6/70) died. Malaise (P = .021, odds ratio 8.390) and detection of pulmonary infiltrations (P < .001, odds ratio 12.563) were the only independent predictors of inpatient treatment in the multivariate analysis. Our data show that RSV is a medically relevant pathogen among adult ED patients, often requiring inpatient treatment. In particular, elderly patients with some medical preconditions seem to be more prone to a severe course of infection requiring inpatient treatment. Lower respiratory tract involvement, proven by pulmonary infiltrates, seems to be crucial for a more severe disease course.
Identifiants
pubmed: 39331940
doi: 10.1097/MD.0000000000039265
pii: 00005792-202409270-00083
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e39265Informations de copyright
Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
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