Disease burden caused by respiratory syncytial virus compared with influenza among adults: a retrospective cohort study from Eastern Finland in 2017–2018

Abstract

ObjectivesRespiratory syncytial virus (RSV) is one of the most important causes of lower respiratory tract illnesses. In this study, we examined the number and severity of RSV infections among adult patients. The underlying diseases and background information of patients with RSV were examined and compared with the patients with influenza.DesignRetrospective cohort study.SettingPatients receiving tertiary care services in Kuopio University Hospital (KUH) district in Eastern Finland.Participants725 patients (152 with RSV infection and 573 with influenza) treated in KUH between November 2017 and May 2018.Primary and secondary outcome measuresHospitalisation and mortality.ResultsCompared with influenza, RSV caused a more serious disease in terms of hospitalisation (84.2% vs 66.0%, p<0.001), incidence of pneumonia (37.5% vs 23.2%, p<0.001), need for antibiotics (67.1% vs 47.3%, p<0.001) and supplemental oxygen (50.7% vs 31.2%, p<0.001). The all-cause mortality during hospitalisation and 30 days after discharge was higher among the RSV-infected patients (8.6% vs 3.5%, p=0.010). Solid malignancies (23.1% vs 5.0%, p=0.042) and chronic kidney disease (30.8% vs 5.8%, p=0.011) were more common among the RSV-infected non-survivors compared with survivors. RSV was an independent risk factor for hospitalisation (adjusted OR (aOR) 2.035; 95% CI 1.17 to 3.55) and mortality (aOR 2.288; 95% CI 1.09 to 4.81) compared with influenza.ConclusionsAmong all the screened patients, those with RSV infection were older and had more underlying conditions than patients with influenza. They had increased likelihood of hospitalisation and mortality when compared with influenza. Solid malignancies and chronic kidney disease seemed to be independent risk factors for death among RSV-infected patients. During RSV and influenza epidemics, it is important to test patients with respiratory symptoms for RSV and influenza to prevent the spread of the infections among elderly and chronically ill patients.

Resurgence of influenza and respiratory syncytial virus in Egypt following two years of decline during the COVID-19 pandemic: outpatient clinic survey of infants and children, October 2022

“…Broadening of Egypt ARI surveillance laboratory testing panel to include RSV and other respiratory viruses is recommended to better characterize the relative burden of ARI in Egypt. During RSV and influenza epidemics, it is particularly important to test for influenza and RSV to better identify the causative virus and prevent infection from spreading to elderly and chronically ill individuals [ 43 – 44 ].…”

From Forgotten Pathogen to Target for New Vaccines: What Clinicians Need to Know about Respiratory Syncytial Virus Infection in Older Adults

“…In the last four years, several systematic reviews and meta-analyses were published [ 15 , 16 , 17 , 25 , 27 , 29 , 31 , 32 , 41 ], most of them with the aim to define the disease burden of RSV in older adults and some of them with the active participation of pharma companies involved in RSV vaccine and drug development. Several clinical studies have been published over the years worldwide [ 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 ]. In Europe, what emerged together with the findings of few multicenter clinical studies [ 21 , 59 , 60 , 61 , 62 , 63 , 64 , 65 ] was the need to harmonize and collaborate between the various laboratories in order to obtain shared diagnostic protocols with which to compare data...…”

Respiratory syncytial virus infection in the modern era

“…A systematic review and meta-analysis has shown that RSV and influenza virus infection of older adults leads to a similar rate of hospitalization and mortality [25]. In contrast, a retrospective cohort study from Eastern Finland in 2017–2018 showed that RSV-infected patients were older and had an increased risk of hospitalization and mortality in comparison to influenza virus-infected adults [26 ▪▪ ]. The level of RSV infection in adults and older adults may also be underestimated due to limitations in diagnostic testing, a situation that could be alleviated by the collection and testing of three or more specimen types from patients [27].…”