住院成人呼吸道合胞病毒感染的发病率和死亡率：与季节性流感的比较。
Morbidity and mortality of respiratory syncytial virus infection in hospitalized adults: Comparison with seasonal influenza.
机构信息
Infectious Disease Unit, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel; Internal Medicine Department E, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel.
出版信息
Int J Infect Dis. 2021 Feb;103:489-493. doi: 10.1016/j.ijid.2020.11.185. Epub 2020 Nov 26.
INTRODUCTION
Respiratory syncytial virus (RSV) is considered a major pathogen that causes acute influenza-like illness. The objective of this study was to compare the clinical outcomes of patients with laboratory-confirmed RSV and patients with influenza infection.
METHODS
Adults hospitalized in Beilinson Hospital (October 2017-April 2018) with laboratory-confirmed RSV or influenza were included. The primary outcome was the composite of RSV/influenza complications: 30-day mortality, pneumonia, mechanical ventilation, vasopressor support, intensive care unit admission, and myocarditis/encephalitis. Secondary outcomes were individual components of the primary outcome, 90-day mortality, 90-day readmission, and length of hospital stay.
RESULTS
A total of 639 patients with RSV (n = 113) and influenza (n = 526) were included. The composite primary outcome was 21.4% (136/633), and was higher in RSV patients (30% (34/113) vs 19% (102/526), p = 0.002). Pneumonia was more common in RSV patients (21.2% (24/113) vs 9.1% (48/526), p = 0.001). On multivariable analysis, hypoalbuminemia (odds ratio (OR) 3.3, 95% confidence interval (CI) 2.1-5.3, p < 0.001), reduced room-air saturation (OR 1.1, 95% CI 1.02-1.1, p = 0.001), and infection with RSV (OR 1.67, 95% CI 1.01-2.76, p = 0.046) were predictors of complications.
CONCLUSIONS
RSV infection in hospitalized adults resulted in serious respiratory illness with complications that are comparable to those caused by influenza.
简介
呼吸道合胞病毒（RSV）被认为是导致急性流感样疾病的主要病原体。本研究的目的是比较实验室确诊的 RSV 患者和流感感染患者的临床结局。
方法
纳入 2017 年 10 月至 2018 年 4 月在贝林松医院住院的实验室确诊的 RSV 或流感患者。主要结局是 RSV/流感并发症的综合结果：30 天死亡率、肺炎、机械通气、血管加压素支持、重症监护病房入院和心肌炎/脑炎。次要结局是主要结局的各个组成部分、90 天死亡率、90 天再入院和住院时间。
结果
共纳入 639 例 RSV 患者（n=113）和流感患者（n=526）。复合主要结局为 21.4%（136/633），在 RSV 患者中更高（30%（34/113）比 19%（102/526），p=0.002）。肺炎在 RSV 患者中更为常见（21.2%（24/113）比 9.1%（48/526），p=0.001）。多变量分析显示，低白蛋白血症（优势比（OR）3.3，95%置信区间（CI）2.1-5.3，p<0.001）、降低的室内空气饱和度（OR 1.1，95%CI 1.02-1.1，p=0.001）和 RSV 感染（OR 1.67，95%CI 1.01-2.76，p=0.046）是并发症的预测因素。
结论
住院成人的 RSV 感染导致严重的呼吸道疾病，其并发症与流感引起的并发症相当。
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