Mitratza Marianna, Elsobky Malak, Liang Caihua, Bruyndonckx Robin, Polkowska-Kramek Aleksandra, Ewnetu Worku Biyadgie, Peerawaranun Pimnara, Tran Thao Mai Phuong, Nuttens Charles, Grajales Ana Gabriela, Nzula Sazini, Gessner Bradford D, Begier Elizabeth
P95 Epidemiology and Pharmacovigilance, Leuven, Belgium.
Pfizer Canada Inc, Kirkland, Canada.
Infect Dis Ther. 2024 Sep;13(9):1949-1962. doi: 10.1007/s40121-024-01018-w. Epub 2024 Jul 15.
Adult respiratory syncytial virus (RSV) burden is underestimated due to non-specific symptoms, limited standard-of-care and delayed testing, reduced diagnostic test sensitivity-particularly when using single diagnostic specimen-when compared to children, and variable test sensitivity based on the upper airway specimen source. We estimated RSV-attributable hospitalization incidence among adults aged ≥ 18 years in Ontario, Canada, using a retrospective time-series model-based approach.
The Institute for Clinical Evaluative Sciences data repository provided weekly numbers of hospitalizations (from 2013 to 2019) for respiratory, cardiovascular, and cardiorespiratory disorders. The number of hospitalizations attributable to RSV was estimated using a quasi-Poisson regression model that considered probable overdispersion and was based on periodic and aperiodic time trends and viral activity. As proxies for viral activity, weekly counts of RSV and influenza hospitalizations in children under 2 years and adults aged 60 years and over, respectively, were employed. Models were stratified by age and risk group.
In patients ≥ 60 years, RSV-attributable incidence rates were high for cardiorespiratory hospitalizations (range [mean] in 2013-2019: 186-246 [215] per 100,000 person-years, 3‒4% of all cardiorespiratory hospitalizations), and subgroups including respiratory hospitalizations (144-192 [167] per 100,000 person-years, 5‒7% of all respiratory hospitalizations) and cardiovascular hospitalizations (95-126 [110] per 100,000 person-years, 2‒3% of all cardiovascular hospitalizations). RSV-attributable cardiorespiratory hospitalization incidence increased with age, from 14-18 [17] hospitalizations per 100,000 person-years (18-49 years) to 317-411 [362] per 100,000 person-years (≥ 75 years).
Estimated RSV-attributable respiratory hospitalization incidence among people ≥ 60 years in Ontario, Canada, is comparable to other incidence estimates from high-income countries, including model-based and pooled prospective estimates. Recently introduced RSV vaccines could have a substantial public health impact.
成人呼吸道合胞病毒（RSV）负担被低估，原因包括症状不具特异性、标准治疗有限且检测延迟、与儿童相比诊断检测灵敏度降低（尤其是使用单一诊断标本时）以及基于上呼吸道标本来源的检测灵敏度存在差异。我们采用基于回顾性时间序列模型的方法，估算了加拿大安大略省18岁及以上成年人中RSV所致住院发病率。
临床评估科学研究所的数据储存库提供了（2013年至2019年）呼吸、心血管和心肺疾病的每周住院人数。使用考虑了可能的过度离散且基于周期性和非周期性时间趋势以及病毒活性的准泊松回归模型，估算RSV所致的住院人数。分别采用2岁以下儿童和60岁及以上成年人中RSV和流感住院的每周计数作为病毒活性的替代指标。模型按年龄和风险组进行分层。
在60岁及以上患者中，RSV所致心肺住院发病率较高（2013 - 2019年范围[均值]：每10万人年186 - 246例[215例]，占所有心肺住院病例的3 - 4%），包括呼吸住院（每10万人年144 - 192例[167例]，占所有呼吸住院病例的5 - 7%）和心血管住院（每10万人年95 - 126例[110例]，占所有心血管住院病例的2 - 3%）的亚组。RSV所致心肺住院发病率随年龄增加，从每10万人年14 - 18例[17例]（18 - 49岁）增至每10万人年317 - 411例[362例]（75岁及以上）。
加拿大安大略省60岁及以上人群中RSV所致呼吸住院发病率估算值与高收入国家的其他发病率估算值相当，包括基于模型和汇总的前瞻性估算值。最近推出的RSV疫苗可能对公共卫生产生重大影响。
