Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan.
School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
Rev Med Virol. 2024 Nov;34(6):e70003. doi: 10.1002/rmv.70003.
Respiratory syncytial virus (RSV) represents a significant burden on older adults (aged ≥ 50 years) globally and can lead to acute respiratory tract infections with substantial morbidity and mortality. However, there is a significant gap in knowledge regarding RSV infection in older adults, particularly in the Asia-Pacific region. This knowledge gap underscores the need for targeted and comprehensive studies to fully understand the nuanced epidemiology of RSV in ageing populations. This review synthesises data from various countries, emphasising the impact of RSV on older populations in the Asia-Pacific region. The overall proportions of RSV-related ARIs among older patients ranged from 0.2% to 5.6%. Among older adult patients with CAP, RSV accounted for 1.1%-10.3% of cases. However, it is crucial to note that the diversity in reported percentages highlights the influence of factors such as geographic location, health care settings and diagnostic practices. The most common symptoms observed in older adults with RSV infection were cough, sputum production and fever, followed by dyspnoea, sore throat and rhinorrhoea. Most of the old adults with RSV infection had underlying diseases, and RSV can cause significant morbidity and mortality in old adults. Treatment of RSV infections predominantly involve supportive care, with aerosolised ribavirin reserved for severe cases, especially immunocompromised patients. Emerging antiviral agents, including fusion and nucleoprotein inhibitors, offer promising avenues for future therapeutics. The recent approval of the bivalent RSV prefusion F protein-based vaccine for individuals aged 60 and older represents a milestone in preventive strategies. In conclusion, RSV infection remains a significant threat to older adults in the Asia-Pacific region, necessitating ongoing research and surveillance efforts. The recent vaccine approval marks a positive milestone, but further studies are crucial for refining prevention and treatment approaches.
呼吸道合胞病毒（RSV）在全球范围内给老年人（年龄≥50 岁）带来了巨大负担，可导致急性呼吸道感染，发病率和死亡率高。然而，人们对老年人 RSV 感染的认识存在重大差距，特别是在亚太地区。这一知识差距凸显了需要进行有针对性和全面的研究，以充分了解 RSV 在老年人群中的细微流行病学。本综述综合了来自不同国家的数据，强调了 RSV 对亚太地区老年人群的影响。老年患者中 RSV 相关 ARI 的总体比例为 0.2%至 5.6%。在老年社区获得性肺炎（CAP）患者中，RSV 占 1.1%至 10.3%。然而，必须指出的是，报告的百分比差异很大，这突出表明地理位置、医疗保健环境和诊断实践等因素的影响。老年 RSV 感染患者最常见的症状是咳嗽、咳痰和发热，其次是呼吸困难、咽痛和流涕。大多数老年 RSV 感染患者有基础疾病，RSV 可导致老年患者出现显著的发病率和死亡率。RSV 感染的治疗主要包括支持性治疗，雾化利巴韦林保留给重症病例，特别是免疫功能低下的患者。新兴的抗病毒药物，包括融合和核蛋白抑制剂，为未来的治疗提供了有前途的途径。最近批准的二价 RSV 融合前 F 蛋白疫苗适用于 60 岁及以上人群，这是预防策略中的一个里程碑。总之，RSV 感染仍然是亚太地区老年人的重大威胁，需要持续进行研究和监测工作。最近的疫苗批准标志着一个积极的里程碑，但进一步的研究对于完善预防和治疗方法至关重要。
