Belongia Edward A, King Jennifer P, Kieke Burney A, Pluta Joanna, Al-Hilli Ali, Meece Jennifer K, Shinde Vivek
Marshfield Clinic Research Institute, Marshfield, Wisconsin.
Marshfield Clinic Health System, Marshfield, Wisconsin.
Open Forum Infect Dis. 2018 Nov 27;5(12):ofy316. doi: 10.1093/ofid/ofy316. eCollection 2018 Dec.
The epidemiology and burden of respiratory syncytial virus (RSV) illness are not well defined in older adults.
Adults ≥60 years old seeking outpatient care for acute respiratory illness were recruited from 2004-2005 through 2015-2016 during the winter seasons. RSV was identified from respiratory swabs by multiplex polymerase chain reaction. Clinical characteristics and outcomes were ascertained by interview and medical record abstraction. The incidence of medically attended RSV was estimated for each seasonal cohort.
RSV was identified in 243 (11%) of 2257 enrollments (241 of 1832 individuals), including 121 RSV type A and 122 RSV type B. The RSV clinical outcome was serious in 47 (19%), moderate in 155 (64%), and mild in 41 (17%). Serious outcomes included hospital admission (n = 29), emergency department visit (n = 13), and pneumonia (n = 23) and were associated with lower respiratory tract symptoms during the enrollment visit. Moderate outcomes included receipt of a new antibiotic prescription (n = 144; 59%), bronchodilator/nebulizer (n = 45; 19%), or systemic corticosteroids (n = 28; 12%). The relative risk of a serious outcome was significantly increased in persons aged ≥75 years (vs 60-64 years) and in those with chronic obstructive pulmonary disease or congestive heart failure. The average seasonal incidence was 139 cases/10 000, and it was significantly higher in persons with cardiopulmonary disease compared with others (rate ratio, 1.89; 95% confidence interval, 1.44-2.48).
RSV causes substantial outpatient illness with lower respiratory tract involvement. Serious outcomes are common in older patients and those with cardiopulmonary disease.
呼吸道合胞病毒（RSV）疾病在老年人中的流行病学特征和疾病负担尚未明确。
在2004 - 2005年至2015 - 2016年冬季，招募年龄≥60岁因急性呼吸道疾病寻求门诊治疗的成年人。通过多重聚合酶链反应从呼吸道拭子中鉴定RSV。通过访谈和病历摘要确定临床特征和结局。估计每个季节队列中就医的RSV发病率。
在2257例入组者（1832人中的241例）中的243例（11%）中鉴定出RSV，其中包括121例A型RSV和122例B型RSV。RSV的临床结局严重的有47例（19%），中度的有155例（64%），轻度的有41例（17%）。严重结局包括住院（n = 29）、急诊就诊（n = 13）和肺炎（n = 23），且与入组就诊时的下呼吸道症状相关。中度结局包括接受新的抗生素处方（n = 144；59%）、支气管扩张剂/雾化器（n = 45；19%）或全身用糖皮质激素（n = 28；12%）。≥75岁人群（与60 - 64岁相比）以及患有慢性阻塞性肺疾病或充血性心力衰竭的人群出现严重结局的相对风险显著增加。平均季节性发病率为139例/10000，与其他人相比，患有心肺疾病的人群发病率显著更高（率比，1.89；95%置信区间，1.44 - 2.48）。
RSV导致大量伴有下呼吸道受累的门诊疾病。严重结局在老年患者和患有心肺疾病的患者中很常见。
