Epidemiology, clinical features, and resource utilization associated with respiratory syncytial virus in the community and hospital

Abstract

Background: The epidemiology, clinical features, and resource utilization of respiratory syncytial virus (RSV) cases in the community and the hospital are not fully characterized. Methods:We identified individuals of all ages with laboratory-confirmed RSV from two sources, a community cohort undergoing surveillance for acute respiratory infections (ARIs) and hospitalized patients from the same geographic area of New York City between 2013 and 15. The epidemiology, clinical features, and resource utilization (antibiotic/steroid/ribavirin usage, chest X-rays, respiratory-support (continuous positive airway pressure [CPAP], mechanical ventilation or extracorporeal membrane oxygenation [ECMO]), and indicators of disease severity (respiratory-support, and/ or ICU admission or death)) were compared among age groups using univariate and bivariate analyses. Results:In the community cohort (1777 people with 1805 ARIs), 66(3.7%) tested RSV-positive (3.8% of <1-year-olds; 3.8% of adults ≥65); 40.9% were medically attended, and 23.1% reported antibiotic usage. Among 40,461 tests performed on hospital patients, 2.7% were RSV-positive within ± 2 days of admission (37.3% <1 year old; 17.4% ≥65 years old). Among RSV-positive hospitalized adults ≥65%, 92.7%, 89.6% and 78.1% received a chest X-ray, antibiotics and/or steroids respectively, compared with 48.9%, 45.7%, and 48.7% of children <1. Severe illness occurred in 27.0% RSV-positive hospitalized <1-year-olds and 19.8% ≥65-year-olds. Conclusions:Respiratory syncytial virus had a demonstrated impact in the community and hospital. Only 40% of RSV community cases were medically attended. In the hospitalized-cohort, <1-and ≥ 65-year-olds accounted for the majority of patients and had similar rates of severe illness. In addition, resource utilization was high in

Assessment of the Effects of Active Immunisation against Respiratory Syncytial Virus (RSV) using Decision-Analytic Models: A Systematic Review with a Focus on Vaccination Strategies, Modelling Methods and Input Data

“…Asymptomatic or mild RSV reinfections are common in adult life [10], with more severe manifestation in immunocompromised individuals [11], patients with cardiopulmonary diseases, and the elderly [12]. The increasing evidence on RSV in the elderly suggests that the impact of the disease is non-negligible, particularly in people with underlying comorbidities, and is comparable to that of non-pandemic influenza [12][13][14].…”

“…Overall, RSV infection has been recognised as a disease with a considerable impact in the community and on hospital services that requires prevention in young children and older adults [14]. Currently, the only preventive strategy is passive immunisation since active immunisation is not yet available.…”

Viruses of Respiratory Tract: an Observational Retrospective Study on Hospitalized Patients in Rome, Italy

“…The identified viral agents included all the respiratory viruses commonly circulating in the community as well as in the hospital setting, namely FLU A and B viruses, RHV/EV, HCOV, RSV, HMPV, PIV and ADV, as already reported by other authors [8][9][10]. It is well known that the knowledge and monitoring of the prevalence of respiratory viruses in hospital settings is very important, as the impact of these infections in hospitalized patients can have more serious consequences than in the general population [1][2][3][4][8][9][10][11][12][13][14][15][16][17].…”

Assessing the effects of meteorological factors on daily children's respiratory disease hospitalizations: A retrospective study

“…For instance, the respiratory syncytial virus exhibits notable seasonal distributions, namely, beginning in early autumn, peaking at the end of November or in early December, and gradually decreasing in spring. However, adenovirus, influenza, and human parainfluenza virus were more frequently detected in the spring and summer months, between March and August [ 25 , 26 ]. A study on the admission of children with respiratory diseases in Beijing showed that the most common diagnosis (86.11%) in the adenovirus-positive cases was pneumonia, which was accompanied by common signs and symptoms of fever and cough [ 14 ].…”