Jimeno Ruiz Sara, Peláez Adrián, Calle Gómez Ángeles, Villarreal García-Lomas Mercedes, Martínez Silvina Natalini
Departamento de Pediatría, Hospital HM Puerta del Sur, HM Hospitales, 28938 Madrid, Spain.
Unidad de Vacunas, HM Hospitales, 28938 Madrid, Spain.
Geriatrics (Basel). 2024 Nov 6;9(6):145. doi: 10.3390/geriatrics9060145.
: Respiratory illnesses frequently lead to hospitalization in adults aged 60 and older, especially due to respiratory viral infectious (RVI). This study investigates hospitalization patterns and characteristics of RVI at HM Hospitals from October 2023 to March 2024; : We retrospectively explored hospitalizations of patients aged 60 years and older with RVIs, gathering data on demographics, clinical profiles, comorbidities, and treatments. Outcomes included hospitalization, ICU admissions, and mortality, and independent factors associated with outcomes were identified using a multi-state model; : From October 2023 to March 2024, from a total of 3258 hospitalizations, 1933 (59.3%) were identified as positive for RVIs. Overall, SARS-CoV-2 was the most prevalent (52.6%), followed by influenza (32.7%), and RSV (11.8%). Most RVI involved single infections (88.2%). Hospitalization rates increased with age for SARS-CoV-2 (333.4 [95% CI: 295.0-375.2] to 651.6 [95% CI: 532.1-788.4]), influenza (169.8 [95% CI: 142.6-200.7] to 518.6 [95% CI: 412.1-643.1]), and RSV (69.2 [95% CI: 52.2-90.0] to 246.0 [95% CI: 173.8-337.5]), with SARS-CoV-2 showing the highest rate, followed by influenza and RSV. In the multi-state model, RSV infection significantly increased ICU admission risk (HR: 2.1, 95%, = 0.037). Age on admission (HR: 1.1, 95%, < 0.001) and Charlson score (HR: 1.4, 95%, = 0.001) were associated with transitioning from admission to death. ICU to death risks included age at admission (HR: 1.7, 95%, < 0.001); : RVI in adults 60 years and older are associated with high hospitalization and mortality rates, primarily driven by influenza and SARS-CoV-2, followed by RSV. Age and comorbidities significantly impact disease severity, emphasizing the need for targeted prevention and management strategies for RSV in this vulnerable population.
呼吸系统疾病经常导致60岁及以上成年人住院，尤其是由于呼吸道病毒感染（RVI）。本研究调查了2023年10月至2024年3月期间HM医院RVI的住院模式和特征：我们回顾性地探讨了60岁及以上患有RVI患者的住院情况，收集了人口统计学、临床特征、合并症和治疗方面的数据。结果包括住院、入住重症监护病房（ICU）和死亡率，并使用多状态模型确定与结果相关的独立因素；从2023年10月至2024年3月，在总共3258例住院病例中，1933例（59.3%）被确定为RVI阳性。总体而言，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）最为常见（52.6%），其次是流感（32.7%）和呼吸道合胞病毒（RSV，11.8%）。大多数RVI为单一感染（88.2%）。SARS-CoV-2、流感和RSV的住院率均随年龄增长而升高，SARS-CoV-2的住院率最高（333.4[95%置信区间：295.0 - 375.2]至651.6[95%置信区间：532.1 - 788.4]），其次是流感（169.8[95%置信区间：142.6 - 200.7]至518.6[95%置信区间：412.1 - 643.1]）和RSV（69.2[95%置信区间：52.2 - 90.0]至246.0[95%置信区间：173.8 - 337.5]）。在多状态模型中，RSV感染显著增加了入住ICU的风险（风险比：2.1，95%，P = 0.037）。入院时年龄（风险比：1.1，95%，P < 0.001）和查尔森评分（风险比：1.4，95%，P = 0.001）与从入院到死亡的转变相关。从ICU到死亡的风险包括入院时年龄（风险比：1.7，95%，P < 0.001）；60岁及以上成年人的RVI与高住院率和死亡率相关，主要由流感和SARS-CoV-2引起，其次是RSV。年龄和合并症显著影响疾病严重程度，强调了针对这一脆弱人群制定RSV针对性预防和管理策略的必要性。
