老年人及被认为有严重感染高风险的成年人中呼吸道合胞病毒的疾病负担。
Burden of disease of respiratory syncytial virus in older adults and adults considered at high risk of severe infection.
作者信息
Abrams Elissa M, Doyon-Plourde Pamela, Davis Phaedra, Lee Liza, Rahal Abbas, Brousseau Nicholas, Siu Winnie, Killikelly April
机构信息
Public Health Agency of Canada, Ottawa, ON.
Section of Allergy and Clinical Immunology, Department of Pediatrics, University of Manitoba, Winnipeg, MB.
出版信息
Can Commun Dis Rep. 2025 Jan 2;51(1):26-34. doi: 10.14745/ccdr.v51i01a04. eCollection 2025 Jan.
BACKGROUND
Availability of new vaccines for adults has increased interest in understanding Canada's respiratory syncytial virus (RSV) burden in older adults and adults considered at high risk of severe infection.
OBJECTIVE
To characterize the burden of RSV disease in Canada by joint analysis of the published literature and hospitalization data from a healthcare administrative database.
METHODS
Electronic databases of published literature were searched to identify studies and systematic reviews reporting data on outpatient visits, hospitalizations, intensive care unit (ICU) admissions and deaths associated with RSV infection in adults. For the hospitalization data analysis, hospital discharge records were extracted from the Canadian Institute of Health Information Discharge Abstract Database for all patients admitted to an acute care facility for RSV infection defined by ICD-10 codes from 2010 to 2020 and 2021 to 2023.
RESULTS
Overall, 26 studies, including seven systematic reviews, were identified and summarized. Evidence suggests that medically attended RSV respiratory tract infections (RTI) are frequently causing 4.7%-7.8% of symptomatic RTI in adults 60 years of age and older. Incidence of RSV RTI increases with age and presence of underlying medical conditions. This trend was consistently observed across all RSV clinical outcomes of interest. Patients who reside in long-term care or other chronic care facilities have a higher likelihood of severe clinical outcomes compared to patients with other living situations upon hospital admission. Approximately 10% of older adults hospitalized with RSV infection require ICU admission. Although data are limited, the case fatality ratio (CFR) among those admitted to hospital varies between 5% and 10%. Some evidence suggests that RSV burden may be close to the influenza burden in older adults. In general, the results from the Canadian hospitalization data support the rapid review findings. Rates of hospitalization, ICU admission and death associated with RSV all increased with age, with 16% of hospitalizations resulting in ICU admission and with an in-hospital CFR of 9%.
CONCLUSION
In adults, the burden of severe RSV outcomes in general increases with age and presence of comorbidities.
背景
成人新型疫苗的出现，使得人们对了解加拿大老年人以及被认为有严重感染高风险的成年人的呼吸道合胞病毒（RSV）负担更感兴趣。
目的
通过对已发表文献和来自医疗管理数据库的住院数据进行联合分析，描述加拿大RSV疾病的负担。
方法
检索已发表文献的电子数据库，以识别报告成人RSV感染相关门诊就诊、住院、重症监护病房（ICU）入院和死亡数据的研究及系统评价。对于住院数据分析，从加拿大卫生信息研究所出院摘要数据库中提取2010年至2020年以及2021年至2023年因ICD - 10编码定义的RSV感染入住急性护理机构的所有患者的出院记录。
结果
总体而言，共识别并总结了26项研究，其中包括7项系统评价。有证据表明，在60岁及以上的成年人中，接受医疗护理的RSV呼吸道感染（RTI）经常导致4.7% - 7.8%的有症状RTI。RSV RTI的发病率随年龄和潜在疾病的存在而增加。在所有感兴趣的RSV临床结局中均一致观察到这一趋势。与入院时其他生活状况的患者相比，居住在长期护理机构或其他慢性病护理机构的患者出现严重临床结局的可能性更高。约10%因RSV感染住院的老年人需要入住ICU。尽管数据有限，但住院患者的病死率（CFR）在5%至10%之间。一些证据表明，老年人中RSV负担可能接近流感负担。总体而言，加拿大住院数据的结果支持快速综述的发现。与RSV相关的住院率、ICU入院率和死亡率均随年龄增加，16%的住院患者需要入住ICU，住院CFR为9%。
结论
在成年人中，一般而言，严重RSV结局的负担随年龄和合并症的存在而增加。
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