Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA.
Department of Epidemiology, Mailman School of Public Health, New York, NY, USA.
Influenza Other Respir Viruses. 2020 May;14(3):247-256. doi: 10.1111/irv.12723. Epub 2020 Feb 20.
The epidemiology, clinical features, and resource utilization of respiratory syncytial virus (RSV) cases in the community and the hospital are not fully characterized.
We identified individuals of all ages with laboratory-confirmed RSV from two sources, a community cohort undergoing surveillance for acute respiratory infections (ARIs) and hospitalized patients from the same geographic area of New York City between 2013 and 15. The epidemiology, clinical features, and resource utilization (antibiotic/steroid/ribavirin usage, chest X-rays, respiratory-support (continuous positive airway pressure [CPAP], mechanical ventilation or extracorporeal membrane oxygenation [ECMO]), and indicators of disease severity (respiratory-support, and/or ICU admission or death)) were compared among age groups using univariate and bivariate analyses.
In the community cohort (1777 people with 1805 ARIs), 66(3.7%) tested RSV-positive (3.8% of <1-year-olds; 3.8% of adults ≥65); 40.9% were medically attended, and 23.1% reported antibiotic usage. Among 40,461 tests performed on hospital patients, 2.7% were RSV-positive within ± 2 days of admission (37.3% <1 year old; 17.4% ≥65 years old). Among RSV-positive hospitalized adults ≥65%, 92.7%, 89.6% and 78.1% received a chest X-ray, antibiotics and/or steroids respectively, compared with 48.9%, 45.7%, and 48.7% of children <1. Severe illness occurred in 27.0% RSV-positive hospitalized <1-year-olds and 19.8% ≥65-year-olds.
Respiratory syncytial virus had a demonstrated impact in the community and hospital. Only 40% of RSV community cases were medically attended. In the hospitalized-cohort, <1- and ≥ 65-year-olds accounted for the majority of patients and had similar rates of severe illness. In addition, resource utilization was high in older adults, making both young children and older adults important potential RSV vaccine targets.
呼吸道合胞病毒（RSV）在社区和医院中的流行病学、临床特征和资源利用情况尚未完全明确。
我们从两个来源确定了所有年龄的实验室确诊 RSV 病例：一个是进行急性呼吸道感染（ARI）监测的社区队列，另一个是来自纽约市同一地理区域的住院患者。我们使用单变量和双变量分析比较了不同年龄组之间的流行病学、临床特征和资源利用（抗生素/类固醇/利巴韦林使用、胸部 X 光、呼吸支持（持续气道正压通气[CPAP]、机械通气或体外膜氧合[ECMO]）以及疾病严重程度的指标（呼吸支持，以及/或 ICU 入院或死亡））。
在社区队列（1777 人患有 1805 例 ARI）中，有 66 例（3.7%）检测出 RSV 阳性（<1 岁的为 3.8%，≥65 岁的为 3.8%）；40.9%接受了医疗护理，23.1%报告了抗生素使用情况。在对 40461 名住院患者进行的检测中，有 2.7%在入院后±2 天内 RSV 阳性（<1 岁的为 37.3%，≥65 岁的为 17.4%）。在 RSV 阳性的≥65 岁住院成人中，分别有 92.7%、89.6%和 78.1%接受了胸部 X 光、抗生素和/或类固醇治疗，而<1 岁的儿童分别有 48.9%、45.7%和 48.7%接受了治疗。<1 岁的 RSV 阳性住院患儿中有 27.0%出现严重疾病，≥65 岁的患者有 19.8%出现严重疾病。
呼吸道合胞病毒在社区和医院都有明显的影响。只有 40%的 RSV 社区病例接受了医疗护理。在住院患者队列中，<1 岁和≥65 岁的患者占大多数，且严重疾病发生率相似。此外，老年患者的资源利用较高，这使得婴幼儿和老年患者成为呼吸道合胞病毒疫苗的重要潜在目标人群。
