Department of Medicine, Division of Infectious Diseases, University of Rochester, Rochester, New York, USA.
Department of Pediatrics, Columbia University Irving Medical Center, New York, New York, USA.
Influenza Other Respir Viruses. 2022 Nov;16(6):1151-1160. doi: 10.1111/irv.13043. Epub 2022 Sep 7.
Respiratory syncytial virus (RSV) causes severe respiratory illnesses in infants and older adults. Older adults are frequently hospitalized with RSV illness and may experience loss of function. This study evaluated longitudinal changes in function associated with RSV hospitalization in older adults.
Adults ≥60 years hospitalized with laboratory-confirmed RSV were enrolled (N = 302). Demographics and comorbidities were collected. Functional status was assessed 2 weeks pre-hospitalization by recall, at enrollment, hospital discharge and 2, 4, and 6 months post-discharge using the Lawton-Brody Instrumental Activities of Daily Living (IADL) (scale 0-8) and Barthel ADL Index (scale 0-100).
RSV-associated hospitalization resulted in acute functional loss. Median IADL (5 vs. 3, p < 0.0001) and ADL (90 vs. 70, p < 0.0001) scores decreased significantly from pre-hospitalization to admission and remained decreased at discharge. There were no statistically significant differences between pre-hospitalization and 2-, 4-, or 6-month scores. However, 33% and 32% of subjects experienced decreased 6-month IADL and ADL scores, respectively. Additionally, 14% required a higher level of care at discharge. When stratified by pre-hospitalization living situation, 6-month IADL scores declined significantly for those admitted from a skilled nursing facility (3 vs. 1, p = 0.001). In multivariate analysis, male sex and diabetes were associated with a 6-month decline in ADL score of ≥10.
Older adults hospitalized with RSV demonstrate acute functional decline that may become prolonged. Pre-hospitalization living situation may predict patient outcomes. Further study is needed with hospitalized age-matched controls and refined measurement tools to better define the specific impact of RSV on function.
呼吸道合胞病毒（RSV）可导致婴儿和老年人发生严重的呼吸道疾病。老年人常因 RSV 感染住院，可能会出现功能丧失。本研究评估了与老年人 RSV 感染住院相关的功能的纵向变化。
招募了年龄在 60 岁以上、经实验室确诊为 RSV 感染的住院患者（N=302）。收集了人口统计学和合并症信息。使用 Lawton-Brody 工具性日常生活活动（IADL）（评分 0-8）和 Barthel 日常生活活动指数（ADL）（评分 0-100），在入院前 2 周、入院时、出院时以及出院后 2、4 和 6 个月时，通过回忆评估患者的功能状态。
与 RSV 相关的住院治疗导致了急性功能丧失。与入院前相比，IADL（5 分 vs. 3 分，p < 0.0001）和 ADL（90 分 vs. 70 分，p < 0.0001）评分在入院时显著降低，且在出院时仍处于较低水平。与入院前相比，2、4 或 6 个月时的评分没有统计学差异。然而，分别有 33%和 32%的患者出现 6 个月时 IADL 和 ADL 评分下降，此外，有 14%的患者在出院时需要更高水平的护理。根据入院前的居住情况进行分层，从疗养院入院的患者 6 个月时的 IADL 评分明显下降（3 分 vs. 1 分，p=0.001）。在多变量分析中，男性和糖尿病与 ADL 评分下降≥10 分相关。
因 RSV 感染住院的老年人表现出急性功能下降，且这种下降可能会持续较长时间。入院前的居住情况可能预测患者的结局。需要进一步对年龄匹配的住院对照患者进行研究，并使用更精细的测量工具，以更好地定义 RSV 对功能的具体影响。
