Predictors of all‐cause mortality among patients hospitalized with influenza, respiratory syncytial virus, or SARS‐CoV‐2

Hamilton, Mackenzie A.; Liu, Ying; Calzavara, Andrew; Sundaram, Maria E.; Djebli, Mohamed; Darvin, Dariya; Baral, Stefan; Kustra, Rafal; Kwong, Jeffrey C.; Mishra, Sharmistha

doi:10.1111/irv.13004

Cited by 22 publications

(11 citation statements)

References 52 publications

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“…2,20,24 In our dataset, however, comorbidity registered as CCI was not associated with mortality following hospitalisation with a respiratory virus infection. This may seem in contrast to other findings; [25][26][27] however, this in mortality rates following hospitalisation. 9,10,[28][29][30] In the initial phases of the pandemic, changes in admission decisions 31 and improved supportive care 9,32,33 are thought to have contributed most to the decline in mortality.…”

Section: Discussioncontrasting

confidence: 99%

“…In our dataset, however, comorbidity registered as CCI was not associated with mortality following hospitalisation with a respiratory virus infection. This may seem in contrast to other findings; 25–27 however, this discrepancy might in part be explained by a mitigating effect of influenza vaccination in high‐risk individuals, or by a lower admission threshold for those with expected severe progression of disease.…”

Section: Discussioncontrasting

confidence: 60%

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Comparative analysis of mortality in patients admitted with an infection with influenza A/B virus, respiratory syncytial virus, rhinovirus, metapneumovirus or SARS‐CoV‐2

Boon,

Meinders,

van Hannen

et al. 2024

Influenza Resp Viruses

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BackgroundWhile influenza virus and severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) are recognised as a cause of severe illness and mortality, clinical interest for respiratory syncytial virus (RSV), rhinovirus and human metapneumovirus (hMPV) infections is still limited.MethodsWe conducted a retrospective database study comparing baseline characteristics and 30‐day mortality in a large cohort of adult patients admitted for an overnight stay or longer with an influenza virus (A/B), rhinovirus, hMPV, RSV or SARS‐CoV‐2 infection. For non‐SARS‐CoV‐2 viruses, data were included for the period July 2017–February 2020. For SARS‐CoV‐2, data between March 2020 and March 2022 were included.ResultsCovariate‐adjusted 30‐day mortality following RSV, hMPV or rhinovirus infections was substantial (crude mortality 8–10%) and comparable with mortality following hospitalisation with an influenza A virus infection. Mortality following a SARS‐CoV‐2 infection was consistently higher than for any other respiratory virus, at any point in time (crude mortality 14–25%). Odds of mortality for SARS‐CoV‐2 compared with influenza A declined from 4.9 to 1.7 over the course of the pandemic. Patients with SARS‐CoV‐2 infection had less comorbidity than patients with other respiratory virus infections and were more often male. In this cohort, age was related to mortality following hospitalisation, while an association with comorbidity was not apparent.ConclusionsWith the exception of SARS‐CoV‐2 infections, we find the clinical outcome of common respiratory virus infections requiring hospitalisation more similar than often assumed. The observed mortality from SARS‐CoV‐2 was significantly higher, but the difference with other respiratory viruses became less distinct over time.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussioncontrasting

confidence: 60%

Comparative analysis of mortality in patients admitted with an infection with influenza A/B virus, respiratory syncytial virus, rhinovirus, metapneumovirus or SARS‐CoV‐2

Boon,

Meinders,

van Hannen

et al. 2024

Influenza Resp Viruses

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“…The cumulative mortality rate over these three years is comparable to the annual mortality rate reported by other studies of RSV mortality in patients with comorbidities [ 19 ]. A study based on administrative data in Ontario, Canada, reported death rates among hospitalized patients (all ages) of 7.0% for influenza and 2.9% for RSV [ 20 ]. However, data from this paper demonstrated higher mortality when limited to only adults aged 20+ (8.2% for influenza and 10.1% for RSV) [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical features and outcomes of influenza and RSV coinfections: a report from Canadian immunization research network serious outcomes surveillance network

Pott,

J. LeBlanc,

S. ElSherif

et al. 2024

BMC Infect Dis

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Background Influenza and RSV coinfections are not commonly seen but are concerning as they can lead to serious illness and adverse clinical outcomes among vulnerable populations. Here we describe the clinical features and outcomes of influenza and RSV coinfections in hospitalized adults. Methods A cohort study was performed with pooled active surveillance in hospitalized adults ≥ 50 years from the Serious Outcomes Surveillance Network of the Canadian Immunization Research Network (CIRN SOS) during the 2012/13, 2013/14, and 2014/15 influenza seasons. Descriptive statistics summarized the characteristics of influenza/RSV coinfections. Kaplan-Meier estimated the probability of survival over the first 30 days of hospitalization. Results Over three influenza seasons, we identified 33 cases of RSV and influenza coinfection, accounting for 2.39 cases per 1,000 hospitalizations of patients with acute respiratory illnesses. Adults aged 50 + years commonly reported cough (81.8%), shortness of breath (66.7%), sputum production (45.5%), weakness (33.3%), fever (27.3%), and nasal congestion (24.2%) as constitutional and lower respiratory tract infection symptoms. The mortality rate was substantial (12.1%), and age, comorbidity burden, and frailty were associated with a higher risk for adverse clinical outcomes. Conclusions Older adults are at higher risk for complications from influenza and RSV coinfections, especially those over 65 with a high comorbidity burden and frailty.

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“…Another systematic review and meta-analysis found that the in-hospital case fatality rate was higher in adults 65 years of age and older than adults 50 to 64 years of age (1). Similarly, two studies from Ontario found that among patients hospitalized with RSV, 30-day all-cause mortality rates increased with increasing age (12,17). A US prospective cohort study found that the CFR was higher in adults admitted from LTC facilities (38%) than in those admitted from the community (3%, p<0.001) (18).…”

Section: Death Associated With Rsv Infectionmentioning

confidence: 99%

Burden of Disease of Respiratory Syncytial Virus in Older Adults and Adults Considered at High Risk of Severe Infection

Abrams,

Doyon-Plourde,

Davis

et al. 2024

Preprint

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Background: Vaccine products for adults have increased interest in understanding respiratory syncytial virus (RSV) burden in older adults and adults considered at high risk of severe infection in Canada. 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 (CIHI) Discharge Abstract Database (DAD) for all patients admitted to an acute care facility for RSV infection defined by ICD-10 codes from 2010-2020 and 2021-2023. Results: Overall, 26 studies, including 7 systematic reviews, were identified and summarized in the rapid review. Evidence suggests that medically attended RSV respiratory tract infections (RTI) are frequent causing 4.7 to 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, such as cardiorespiratory disease, diabetes, and immunocompromising conditions. This trend was consistently observed across all RSV clinical outcomes of interest (hospitalization, ICU admission and death). Patients who reside in long-term care or other chronic care facilities have higher likelihood of severe clinical outcomes (ICU admission, receiving mechanical ventilation and/or death) 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, evidence suggests that case fatality ratio (CFR) among those admitted to hospital varies between 5 and 10%. Some evidence suggests that RSV burden may be close to 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, risk of severe RSV outcomes in general increases with increasing age and presence of comorbidities.

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Predictors of all‐cause mortality among patients hospitalized with influenza, respiratory syncytial virus, or SARS‐CoV‐2

Cited by 22 publications

References 52 publications

Comparative analysis of mortality in patients admitted with an infection with influenza A/B virus, respiratory syncytial virus, rhinovirus, metapneumovirus or SARS‐CoV‐2

Comparative analysis of mortality in patients admitted with an infection with influenza A/B virus, respiratory syncytial virus, rhinovirus, metapneumovirus or SARS‐CoV‐2

Clinical features and outcomes of influenza and RSV coinfections: a report from Canadian immunization research network serious outcomes surveillance network

Burden of Disease of Respiratory Syncytial Virus in Older Adults and Adults Considered at High Risk of Severe Infection

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