Dept of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Faculty of Medicine and Health Sciences, Antwerp, Belgium.
Eur Respir J. 2021 Apr 1;57(4). doi: 10.1183/13993003.02688-2020. Print 2021 Apr.
Respiratory syncytial virus (RSV) infection in older adults is recognised as an important health issue. We aimed to assess the community burden of RSV in Europe in older adults aged ≥60 years.
This international, prospective, observational cohort study is part of work by the REspiratory Syncytial virus Consortium in EUrope (RESCEU). Participants were recruited through general practitioners' (GPs) offices before two independent RSV seasons. Participants reported weekly about symptoms of acute respiratory tract infection (ARTI) during one RSV season. ARTI patients were tested for RSV during home visits and completed a daily symptom diary. RSV illness included PCR-confirmed ARTI and those showing seroconversion over the season. RSV ARTI was based on PCR alone (ClinicalTrials.gov, NCT03621930).
We recruited 1040 participants (527 in season 2017-2018 and 513 in season 2018-2019) with a median age of 75 years (range 60-100 years). Of these, 1023 (99%) lived independently at home at baseline. RSV illness incidence was 22 out of 527 (4.2%) and 37 out of 513 (7.2%) in the respective seasons. RSV illness did not affect frailty or cardiopulmonary status during the course of the study. No patients were hospitalised or died from RSV illness. In the 36 patients with PCR confirmed RSV ARTI, symptom duration averaged 19 days, while a doctor's visit took place in 11 out of 36 cases (31%). RSV ARTI could not be differentiated clinically from all other ARTIs based on symptoms.
This European study showed that RSV is prevalent in community-dwelling older adults and rarely causes severe disease. This suggests that watchful waiting, using a continuity of care approach to identify those who do need more intensive care, is often justified when RSV is suspected in family practice.
呼吸道合胞病毒（RSV）感染在老年人中被认为是一个重要的健康问题。我们旨在评估欧洲≥60 岁老年人社区中 RSV 的负担。
这是一项国际、前瞻性、观察性队列研究，是欧盟呼吸道合胞病毒联盟（RESCEU）工作的一部分。在两个独立的 RSV 季节之前，通过全科医生（GP）办公室招募参与者。参与者在一个 RSV 季节中每周报告急性呼吸道感染（ARTI）的症状。ARTI 患者在家庭访视中接受 RSV 检测，并填写每日症状日记。RSV 疾病包括 PCR 确诊的 ARTI 和整个季节内出现血清转换的患者。RSV ARTI 仅基于 PCR（ClinicalTrials.gov，NCT03621930）。
我们招募了 1040 名参与者（2017-2018 年季节 527 名，2018-2019 年季节 513 名），中位年龄为 75 岁（范围 60-100 岁）。其中，1023 名（99%）在基线时独立居住在家中。在相应的季节中，22 例（4.2%）和 37 例（7.2%）发生 RSV 疾病。RSV 疾病在研究过程中并未影响脆弱性或心肺状况。没有患者因 RSV 疾病住院或死亡。在 36 例 PCR 确诊的 RSV ARTI 患者中，症状持续时间平均为 19 天，而在 36 例患者中有 11 例（31%）进行了就诊。基于症状，无法将 RSV ARTI 与所有其他 ARTI 进行临床区分。
这项欧洲研究表明，RSV 在社区居住的老年人中普遍存在，很少导致严重疾病。这表明，在家庭实践中怀疑 RSV 时，使用连续性护理方法来识别那些确实需要更密集护理的患者，通常是合理的。
