Osei-Yeboah Richard, Amankwah Stephen, Begier Elizabeth, Adedze Miranda, Nyanzu Franklin, Appiah Pious, Ansah Jochebed Ode Boakye, Campbell Harry, Sato Reiko, Jodar Luis, Gessner Bradford D, Nair Harish
Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK.
Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Warsaw, Poland.
Influenza Other Respir Viruses. 2024 Sep;18(9):e70008. doi: 10.1111/irv.70008.
Older adults in nursing and care homes (NCHs) are vulnerable to severe respiratory syncytial virus (RSV) infection, hospitalization, and death. This study aimed to gather data on RSV disease among older adults in NCHs and identify reported risk factors for RSV hospitalization and case fatality.
The study protocol was registered in PROSPERO (CRD42022371908). We searched MEDLINE, EMBASE, and Global Health databases to identify articles published between 2000 and 2023. Observational and experimental studies conducted among older adults in NCHs requiring assistive care and reporting RSV illness were included and relevant data were extracted.
Of 18,690 studies screened, 32 were selected for full-text review, and 20 were included. Overall, the number of NCH residents ranged from 42 to 1459 with a mean age between 67.6 and 85 years. Attack rates ranged from 6.7% to 47.6% and annual incidence ranged from 0.5% to 14%. Case fatality rates ranged from 7.7% to 23.1%. We found similar annual incidence rates of RSV-positive acute respiratory infection (ARI) of 4582 (95% CI: 3259-6264) and 4785 (95% CI: 2258-10,141) per 100,000 reported in two studies. Annual incidence rate of RSV-positive lower respiratory tract infection was 3040 (95% CI: 1986-4454) cases per 100,000 adults. Annual RSV-ARI hospital admission rates were between 600 (95% CI: 190-10,000) and 1104 (95% CI: 350-1930) per 100,000 person-years. Among all RSV disease cases, commonly reported chronic medical conditions included chronic obstructive pulmonary disease (COPD), heart failure, ischemic heart disease, coronary artery disease, hypertension, diabetes, kidney dysfunction, cerebrovascular accident, malignancies, dementia, and those with a Charlson comorbidity score > 6.5.
Data on RSV infection among NCH residents are limited and largely heterogeneous but document a high risk of illness, frequent hospitalization, and high mortality. Preventive interventions, such as vaccination, should be considered for this high-risk population. Nationally representative epidemiologic studies and NCH-based viral pathogen surveillance could more precisely assess the burden on NCH residents.
养老院和护理机构中的老年人易感染严重的呼吸道合胞病毒（RSV），并易发生住院和死亡。本研究旨在收集养老院中老年人RSV疾病的数据，并确定报告的RSV住院和病死率的危险因素。
该研究方案已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42022371908）登记。我们检索了MEDLINE、EMBASE和全球卫生数据库，以确定2000年至2023年期间发表的文章。纳入了在需要辅助护理的养老院老年人中进行的观察性和实验性研究，这些研究报告了RSV疾病，并提取了相关数据。
在筛选的18690项研究中，32项被选进行全文审查，20项被纳入。总体而言，养老院居民人数从42人到1459人不等，平均年龄在67.6岁至85岁之间。发病率从6.7%到47.6%不等，年发病率从0.5%到14%不等。病死率从7.7%到23.1%不等。我们在两项研究中发现，每10万人中RSV阳性急性呼吸道感染（ARI）的年发病率相似，分别为4582例（95%置信区间：3259 - 6264）和4785例（95%置信区间：2258 - 10141）。RSV阳性下呼吸道感染的年发病率为每10万成年人3040例（95%置信区间：1986 - 4454）。RSV-ARI的年住院率在每10万人年600例（95%置信区间：190 - 10000）至1104例（95%置信区间：350 - 1930）之间。在所有RSV疾病病例中，常见的慢性疾病包括慢性阻塞性肺疾病（COPD）、心力衰竭、缺血性心脏病、冠状动脉疾病、高血压、糖尿病、肾功能不全、脑血管意外、恶性肿瘤、痴呆以及Charlson合并症评分>6.5的患者。
养老院居民中RSV感染的数据有限且差异很大，但记录了疾病风险高、频繁住院和高死亡率的情况。对于这一高危人群，应考虑采取预防干预措施，如接种疫苗。全国代表性的流行病学研究和基于养老院的病毒病原体监测可以更准确地评估养老院居民的负担。
