Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena.
Clinical Development, Novavax Inc., Gaithersburg, Maryland.
Clin Infect Dis. 2019 Jul 2;69(2):197-203. doi: 10.1093/cid/ciy991.
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.
呼吸道合胞病毒（RSV）是导致老年人严重呼吸道疾病的重要原因。比较住院老年人的 RSV 和流感感染情况，可能会提高对成人 RSV 疾病负担的认识。
从 Kaiser Permanente Southern California 电子病历中确定了 2011 年 1 月 1 日至 2015 年 6 月 30 日期间检测出 RSV 或流感呈阳性的 60 岁及以上住院成年人。比较了基本特征、合并症、利用情况和结局。
本研究纳入了 645 例 RSV 感染和 1878 例流感感染住院成年人。与流感感染相比，RSV 感染患者年龄更大（平均年龄 78.5 岁 vs 77.4 岁；P =.035），更有可能在基线时患有充血性心力衰竭（35.3% vs 24.5%；P <.001）和慢性阻塞性肺疾病（COPD）（29.8% vs 24.3%；P =.006）。在调整分析中，RSV 感染与住院时间≥7 天的可能性更大相关（比值比[OR] = 1.5；95%置信区间[CI]，1.2-1.8；P <.001）；肺炎（OR = 2.7；95% CI，2.2-3.2；P <.001）；重症监护病房收治（OR = 1.3；95% CI，1.0-1.7；P =.023）；COPD 恶化（OR = 1.7；95% CI，1.3-2.4；P =.001）；以及入院后 1 年内死亡率更高（OR = 1.3；95% CI，1.0-1.6；P =.019）。
与流感相比，RSV 感染可能导致住院老年成年人的发病率和死亡率更高。提高对成人 RSV 疾病负担的认识，对于评估和使用新的 RSV 疫苗和抗病毒药物非常重要。
