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成人呼吸道合胞病毒感染的流行病学与疾病负担

Epidemiology and Disease Burden of Respiratory Syncytial Virus Infection in Adults.

作者信息

Kim Taeeun, Choi Sang-Ho

机构信息

Division of Infectious Diseases, Department of Medicine, Nowon Eulji University Hospital, Seoul, Korea.

Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Infect Chemother. 2024 Mar;56(1):1-12. doi: 10.3947/ic.2024.0011. Epub 2024 Mar 12.

Abstract

Respiratory syncytial virus (RSV) constitutes a significant cause of respiratory illness and mortality among older adults, a demographic that is expanding with considerable impact on healthcare systems worldwide. The actual burden of RSV in this population may still be underestimated, owing to factors such as low awareness and suboptimal diagnostic sensitivity in adults, the lack of robust RSV surveillance systems, and the infrequent use of diagnostic testing. Recent advancements in respiratory virus detection have spurred further exploration into appropriate preventive and therapeutic strategies. The recent approval of two vaccines highlights the critical need for the precise estimation of the RSV disease burden to optimize the effectiveness and cost-efficiency of immunization programs. This narrative review aimed to summarize the existing knowledge of the RSV burden in adults with a particular focus on older adults, incorporating data from Korea. Overall, current estimates indicate that the annual RSV attack rate in the general adult population ranges from 1 - 7%, increasing to approximately 4 - 10% among elderly and high-risk groups. The in-hospital mortality rate can be estimated to be around 7 - 10%, rising up to 40% among intensive care unit-admitted patients. To elucidate RSV's disease burden, further continuing research, including population-based studies, is necessary.

摘要

呼吸道合胞病毒(RSV)是老年人呼吸道疾病和死亡的重要原因,随着这一人群数量的不断增加,对全球医疗系统产生了重大影响。由于成人对RSV的认识不足、诊断敏感性欠佳、缺乏完善的RSV监测系统以及诊断检测使用不频繁等因素,该人群中RSV的实际负担可能仍被低估。呼吸道病毒检测的最新进展促使人们进一步探索合适的预防和治疗策略。最近两种疫苗的获批凸显了精确估计RSV疾病负担对于优化免疫计划的有效性和成本效益的迫切需求。本叙述性综述旨在总结成人尤其是老年人中RSV负担的现有知识,并纳入来自韩国的数据。总体而言,目前的估计表明,普通成年人群的年RSV感染率在1%-7%之间,老年人和高危人群中这一比例增至约4%-10%。住院死亡率估计约为7%-10%,在入住重症监护病房的患者中升至40%。为阐明RSV的疾病负担,有必要开展包括基于人群的研究在内的进一步持续研究。

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