Bracaloni Sara, Esposito Enrica, Scarpaci Michela, Cosci Tommaso, Casini Beatrice, Chiovelli Federica, Arzilli Guglielmo, Pistello Mauro, Panatto Donatella, Ogliastro Matilde, Loconsole Daniela, Chironna Maria, Rizzo Caterina
Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Department of Health Sciences, University of Genoa, Genoa, Italy.
Influenza Other Respir Viruses. 2024 Dec;18(12):e70049. doi: 10.1111/irv.70049.
Respiratory syncytial virus (RSV) is a major cause of hospital admission in adults over 65, leading to severe complications and death. However, the disease burden in primary care for older adults in Europe is poorly understood. This pilot study aims to test a study protocol for evaluating the clinical burden of RSV in older adults in primary care settings in Italy.
In the 2022-23 winter season, we designed a study on RSV burden in individuals over 65 with acute respiratory infections (ARIs) in Liguria, Apulia, and Tuscany, Italy. Recruited patients underwent nasopharyngeal swabs for RSV confirmation and provided epidemiological and clinical data. RSV-positive patients completed follow-up questionnaires after 14 and 30 days regarding their clinical conditions, healthcare utilization, and socio-economic impact.
We enrolled 152 patients with ARIs; 33 (21.7%) tested positive for RSV. The median disease duration was 14 days, with 3% hospitalized. Among RSV-positive patients, 87% received drug treatment, 52% of whom received antibiotics. After diagnosis, 74% required further GP consultations within 2 weeks. Additionally, 48% incurred extra costs. On day 30, 21% reported health complications or deterioration.
Our pilot study highlights the need for an ARIs surveillance system for older adults in primary care. This is crucial for defining vaccination strategies to reduce the disease burden on these patients and the healthcare system. Moreover, these data are essential for assessing costs and parameters for cost-effectiveness models, facilitating informed decisions in public health planning and resource allocation.
呼吸道合胞病毒（RSV）是65岁以上成年人住院的主要原因，会导致严重并发症和死亡。然而，欧洲初级保健中老年人的疾病负担尚不清楚。这项试点研究旨在测试一项研究方案，以评估意大利初级保健机构中老年人RSV的临床负担。
在2022 - 23年冬季，我们在意大利利古里亚、普利亚和托斯卡纳对65岁以上患有急性呼吸道感染（ARI）的个体进行了一项关于RSV负担的研究。招募的患者接受鼻咽拭子检测以确认RSV，并提供流行病学和临床数据。RSV阳性患者在14天和30天后完成关于其临床状况、医疗保健利用和社会经济影响的随访问卷。
我们招募了152例ARI患者；33例（21.7%）RSV检测呈阳性。疾病中位持续时间为14天，3%的患者住院。在RSV阳性患者中，87%接受了药物治疗，其中52%接受了抗生素治疗。诊断后，74%的患者在2周内需要进一步咨询全科医生。此外，48%的患者产生了额外费用。在第30天，21%的患者报告有健康并发症或病情恶化。
我们的试点研究强调了在初级保健中建立老年人ARI监测系统的必要性。这对于确定疫苗接种策略以减轻这些患者和医疗系统的疾病负担至关重要。此外，这些数据对于评估成本效益模型的成本和参数至关重要，有助于在公共卫生规划和资源分配中做出明智决策。
