Méroc Estelle, Liang Caihua, Iantomasi Raffaella, Onwuchekwa Chukwuemeka, Innocenti Giuseppe Pietro, d'Angela Daniela, Molalign Solomon, Tran Thao Mai Phuong, Basu Somsuvro, Gessner Bradford D, Bruyndonckx Robin, Polkowska-Kramek Aleksandra, Begier Elizabeth
P95 Epidemiology and Pharmacovigilance, Leuven, Belgium.
Pfizer Inc, Milan, Italy.
Infect Dis Ther. 2024 Nov;13(11):2319-2332. doi: 10.1007/s40121-024-01041-x. Epub 2024 Sep 18.
Respiratory syncytial virus (RSV) incidence is known to be underestimated in adults due to its infrequent diagnostic testing and lower sensitivity of single nasal/nasopharyngeal swab PCR testing outside of the early childhood period. RSV can trigger acute cardiac events as well as cause respiratory disease. Consequently, we used a model-based study to estimate RSV-attributable hospitalization and mortality incidence among adults in Italy between 2015 and 2019.
Through a database predisposed by CREA Sanità, by extracting monthly data from the Italian hospitalization collection data of the Ministry of Health and the Italian National Institute of Statistics (ISTAT) data (mortality), we estimated yearly RSV-attributable incidence of events for different cardiorespiratory outcomes. We used a quasi-Poisson regression model, which accounted for periodic and aperiodic time trends and viral activity proxies.
The yearly RSV-attributable cardiorespiratory hospitalization incidence increased with age and was highest among adults aged ≥ 75 years (1064-1527 cases per 100,000 person-years). Similarly, the RSV-attributable cardiorespiratory mortality rate was highest among persons aged ≥ 75 years (59-85 deaths per 100,000 person-years). Incidence rates for RSV-attributable hospitalizations and RSV-attributable mortality were on average 2-3 times higher for cardiorespiratory than respiratory disease alone. Incidence rate based on RSV-specific ICD codes only were 405-1729 times lower than modeled estimates accounting for untested events.
RSV causes a substantial disease burden among adults in Italy and contributes to both respiratory and cardiovascular conditions. Our results emphasize the need for effective RSV prevention strategies, particularly among older adults.
由于呼吸道合胞病毒（RSV）在成人中诊断检测不频繁，且在幼儿期以外单份鼻拭子/鼻咽拭子PCR检测的敏感性较低，其发病率在成人中被低估。RSV可引发急性心脏事件并导致呼吸道疾病。因此，我们采用基于模型的研究来估计2015年至2019年意大利成人中由RSV导致的住院率和死亡率。
通过CREA Sanità预先设定的数据库，从意大利卫生部的住院收集数据和意大利国家统计局（ISTAT）数据（死亡率）中提取月度数据，我们估计了不同心肺结局由RSV导致的年度事件发生率。我们使用了一个准泊松回归模型，该模型考虑了周期性和非周期性时间趋势以及病毒活动指标。
由RSV导致的年度心肺住院率随年龄增长而增加，在75岁及以上的成年人中最高（每10万人年1064 - 1527例）。同样，由RSV导致的心肺死亡率在75岁及以上的人群中最高（每10万人年59 - 85例死亡）。由RSV导致的住院率和死亡率，心肺疾病的发生率平均比仅呼吸道疾病高2 - 3倍。仅基于RSV特异性ICD编码的发生率比考虑未检测事件的模型估计值低405 - 1729倍。
RSV在意大利成人中造成了相当大的疾病负担，并导致呼吸道和心血管疾病。我们的结果强调了需要有效的RSV预防策略，特别是在老年人中。
