Korsten Koos, Welkers Matthijs R A, van de Laar Thijs, Wagemakers Alex, van Hengel Peter, Wever Peter C, Kolwijck Eva
Department of Medical Microbiology and Infection Control, Amsterdam UMC, Amsterdam, the Netherlands.
Department of Medical Microbiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
Influenza Other Respir Viruses. 2025 May;19(5):e70107. doi: 10.1111/irv.70107.
Respiratory syncytial virus can cause severe disease in the older adult population. Three vaccines for RSV are currently market approved but the risk of RSV-hospitalization in (older) adults from a community level remains elusive. We aimed to estimate the risk of RSV-hospitalization and characterize the patients that end up in hospital.
We manually analyzed records of adults aged ≥ 20 with RSV-infection between 2022 and 2024 in three hospitals in the Netherlands. These hospitals implemented routine RSV-testing at emergency departments. Using population-based data in combination with the in-hospital data, we estimated the population risk of RSV-hospitalization. Hospital records were analyzed to characterize the role RSV played in their course of disease.
We analyzed 709 RSV cases of whom 503 (70.9%) were hospitalized. Five hundred twenty-six patients were ≥ 60, and 183 were < 60 years of age. The population RSV-hospitalization rate was 6-20 per 100.000 patients aged 20-59 years and 43-236 per 100.000 for those ≥ 60. The highest risks were observed in those with COPD (1702 per 100.000) and with congestive heart disease (2383 per 100.000). RSV caused clinically relevant infection in 88% of hospitalized cases but was only mentioned using specific ICD-codes in 4.4%. Comorbidity was prevalent (88.5%) and exacerbation of underlying disease caused of 46.3% of RSV-related hospital admissions. ICU admittance was 11.2% and in-hospital mortality was 8.1%.
The risk of RSV-hospitalization from the community is low but is increased substantially in those with underlying disease. RSV is often clinically relevant in hospitalized patients by causing exacerbation of underlying disease but is infrequently mentioned in specific ICD-codes.
呼吸道合胞病毒可在老年人群中引发严重疾病。目前有三种呼吸道合胞病毒疫苗已获市场批准，但社区层面（老年）成年人因呼吸道合胞病毒住院的风险仍不明确。我们旨在估算因呼吸道合胞病毒住院的风险，并描述最终住院患者的特征。
我们人工分析了2022年至2024年期间荷兰三家医院中年龄≥20岁的呼吸道合胞病毒感染成年人的记录。这些医院在急诊科开展了常规呼吸道合胞病毒检测。结合基于人群的数据和住院数据，我们估算了因呼吸道合胞病毒住院的人群风险。对医院记录进行分析，以描述呼吸道合胞病毒在其疾病过程中所起的作用。
我们分析了709例呼吸道合胞病毒病例，其中503例（70.9%）住院。526例患者年龄≥60岁，183例年龄<60岁。年龄在20至59岁的患者中，因呼吸道合胞病毒住院的人群发生率为每100,000人中有6至20例，而60岁及以上人群中这一比例为每100,000人中有43至236例。慢性阻塞性肺疾病患者（每100,000人中有1702例）和充血性心力衰竭患者（每100,000人中有2383例）的风险最高。在88%的住院病例中，呼吸道合胞病毒引发了具有临床相关性的感染，但只有4.4%的病例使用特定国际疾病分类代码提及。合并症很常见（88.5%），基础疾病加重导致46.3%的呼吸道合胞病毒相关住院治疗。重症监护病房入住率为11.2%，住院死亡率为8.1%。
社区中因呼吸道合胞病毒住院的风险较低，但在有基础疾病的人群中风险大幅增加。呼吸道合胞病毒在住院患者中通常通过加重基础疾病而具有临床相关性，但很少在特定国际疾病分类代码中提及。
