Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA.
Value Institute, New York-Presbyterian Hospital, New York, NY, USA.
Influenza Other Respir Viruses. 2021 Sep;15(5):670-677. doi: 10.1111/irv.12842. Epub 2021 Jan 26.
Although the burden of influenza is well characterized, the burden of community-onset non-influenza respiratory viruses has not been systematically assessed. Understanding the severity and seasonality of non-influenza viruses, including human coronaviruses, will provide a better understanding of the overall disease burden from respiratory viruses that could better inform resource utilization for hospitals and highlight the value of preventative strategies, including vaccines.
From October 2017 to September 2019, a retrospective study was performed in a pre-defined catchment area to estimate the population-based incidence of community-onset respiratory viruses associated with hospitalization. Included patients were ≥18 years old, resided in New York City, were hospitalized for ≥24 hours, and had a respiratory virus detected within 3 calendar-days of admission. Disease burden was measured by hospital length of stay (LOS), intensive care unit (ICU) admissions, and in-hospital mortality and compared among those with laboratory-confirmed influenza versus those with laboratory-confirmed non-influenza viruses (human coronaviruses, parainfluenza viruses, respiratory syncytial virus, human metapneumovirus, and adenovirus).
During the study period, 4232 eligible patients were identified of whom 50.9% were ≥65 years of age. For each virus, the population-based incidence was highest for those ≥80 years of age. When compared to those with influenza viruses detected, those with non-influenza respiratory viruses detected (combined) had higher population-based incidence, significantly more ICU admissions, and higher in-house mortality.
The burden of non-influenza respiratory viruses for hospitalized adults is substantial. Prevention and treatment strategies are needed for non-influenza respiratory viruses, particularly for older adults.
尽管流感的负担已得到充分描述，但社区获得性非流感呼吸道病毒的负担尚未得到系统评估。了解包括人类冠状病毒在内的非流感病毒的严重程度和季节性，将有助于更好地了解呼吸道病毒的整体疾病负担，从而更好地为医院利用资源提供信息，并突出预防策略（包括疫苗）的价值。
从 2017 年 10 月到 2019 年 9 月，在一个预先确定的集水区内进行了一项回顾性研究，以估计与住院相关的社区获得性呼吸道病毒的人群发病率。纳入的患者年龄≥18 岁，居住在纽约市，住院时间≥24 小时，并且在入院后 3 个日历日内检测到呼吸道病毒。通过住院时间（LOS）、重症监护病房（ICU）入院和院内死亡率来衡量疾病负担，并在实验室确诊流感患者与实验室确诊非流感病毒（人类冠状病毒、副流感病毒、呼吸道合胞病毒、人偏肺病毒和腺病毒）患者之间进行比较。
在研究期间，确定了 4232 名符合条件的患者，其中 50.9%的患者年龄≥65 岁。对于每种病毒，年龄≥80 岁的人群发病率最高。与检测到流感病毒的患者相比，检测到非流感呼吸道病毒（联合）的患者具有更高的人群发病率、更多的 ICU 入院和更高的院内死亡率。
住院成人中非流感呼吸道病毒的负担很大。需要针对非流感呼吸道病毒，特别是老年人，制定预防和治疗策略。
