Seasonal Incidence of Medically Attended Respiratory Syncytial Virus Infection in a Community Cohort of Adults ≥50 Years Old

McClure, David L.; Kieke, Burney A.; Sundaram, Maria E.; Simpson, Melissa; Meece, Jennifer K.; Sifakis, Frangiscos; Gasser, Robert A.; Belongia, Edward A.

doi:10.1371/journal.pone.0102586

Cited by 65 publications

(68 citation statements)

References 22 publications

(26 reference statements)

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“…Most (87.0%) adult hospitalized patients with RSV infection of age ≥ 50 years had comorbidities. RSV is an important pathogen not only in patients of age ≥ 65 years but also in the age range 50-64 years, which was similar to previous studies [9,19,20]. Nevertheless, we found the highest prevalence in age range 65-79 years (36.2%).…”

Section: Discussionsupporting

confidence: 91%

Clinical manifestations and outcomes of respiratory syncytial virus infection in adult hospitalized patients

Chuaychoo

Ngamwongwan

Kaewnaphan

et al. 2019

Journal of Clinical Virology

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Background: Respiratory syncytial virus (RSV) is an important virus found in adult hospitalized patients.Objectives: To study the clinical outcomes of hospitalized patients aged ≥ 15 years and diagnosed with RSV infection. Study design: Both retrospective and prospective cohort studies were conducted at a university hospital between May 2014 and December 2015. Results: RSV was detected in 86 of 1562(5.5%) adult hospitalized patients suspected of respiratory viral infection. Sixty-nine patients were included in the study. RSV was detected by RT-PCR (82.6%), IFA (10.1%), and both RT-PCR and IFA (7.3%). Most patients (87.0%) were aged ≥ 50 years. Cardiovascular diseases, pulmonary diseases, immunocompromised hosts, and diabetes were the major comorbidities. The common manifestations were cough (92.8%), dyspnea (91.3%), sputum production (87.0%), tachypnea (75.4%), wheezing (73.9%), and fever (71.0%). Fifty-five patients (79.7%) were diagnosed with pneumonia. Hypoxemia (SpO2 ≤ 92%) was found in 53.6% patients. Twenty-five of 69(36.2%) patients developed respiratory failure and required ventilatory support. Cardiovascular complications were found in 24.6% of patients. Congestive heart failure, acute myocardial infarction (MI), new atrial fibrillation, and supraventricular tachycardia were found in 9(13.0%), 7(10.1%), 4(5.8%), and 3(4.3%) of 69 patients, respectively. Overall mortality was 15.9%. Pneumonia (81.8%) and acute MI (18.2%) were the major causes of death. Conclusions: Most adult hospitalized patients with RSV infection were of advanced age and had comorbidities. Cardiopulmonary complications were the major causes of death. Management and prevention of RSV infection in these vulnerable groups are necessary.

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Section: Discussionsupporting

confidence: 91%

Clinical manifestations and outcomes of respiratory syncytial virus infection in adult hospitalized patients

Chuaychoo

Ngamwongwan

Kaewnaphan

et al. 2019

Journal of Clinical Virology

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“…Advanced age, cough, nasal congestion, wheezing, and increasing interval from symptom onset to care-seeking were independently associated with RSV detection. The latter study was conducted in a Wisconsin community cohort, and the overall seasonal incidence of medically attended RSV illness was estimated as 154 episodes per 10 000 individuals M A J O R A R T I C L E ≥50 years old [20]. The incidence of medically attended RSV increased with age, and it was highest (199 episodes per 10 000) among persons ≥70 years of age.…”

mentioning

confidence: 99%

Clinical Features, Severity, and Incidence of RSV Illness During 12 Consecutive Seasons in a Community Cohort of Adults ≥60 Years Old

Belongia

King

Kieke

et al. 2018

Open Forum Infectious Diseases

100

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BackgroundThe epidemiology and burden of respiratory syncytial virus (RSV) illness are not well defined in older adults.MethodsAdults ≥60 years old seeking outpatient care for acute respiratory illness were recruited from 2004–2005 through 2015–2016 during the winter seasons. RSV was identified from respiratory swabs by multiplex polymerase chain reaction. Clinical characteristics and outcomes were ascertained by interview and medical record abstraction. The incidence of medically attended RSV was estimated for each seasonal cohort.ResultsRSV was identified in 243 (11%) of 2257 enrollments (241 of 1832 individuals), including 121 RSV type A and 122 RSV type B. The RSV clinical outcome was serious in 47 (19%), moderate in 155 (64%), and mild in 41 (17%). Serious outcomes included hospital admission (n = 29), emergency department visit (n = 13), and pneumonia (n = 23) and were associated with lower respiratory tract symptoms during the enrollment visit. Moderate outcomes included receipt of a new antibiotic prescription (n = 144; 59%), bronchodilator/nebulizer (n = 45; 19%), or systemic corticosteroids (n = 28; 12%). The relative risk of a serious outcome was significantly increased in persons aged ≥75 years (vs 60–64 years) and in those with chronic obstructive pulmonary disease or congestive heart failure. The average seasonal incidence was 139 cases/10 000, and it was significantly higher in persons with cardiopulmonary disease compared with others (rate ratio, 1.89; 95% confidence interval, 1.44–2.48).ConclusionsRSV causes substantial outpatient illness with lower respiratory tract involvement. Serious outcomes are common in older patients and those with cardiopulmonary disease.

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“…The age strata included in such analyses should include the oldest age groups (eg, 80 years and older). Studies have documented disease incidence and rates of MAARI and hospitalizations in one aggregate age group in adults (eg, 65 years and older) [11,12], but using finer age strata to document how burden changes as adults age will be important, yet challenging [13]. In addition, RSV disease severity measures in several age groups across years are needed.…”

Section: Surveillance For Burden Estimatesmentioning

confidence: 99%

Identifying Gaps in Respiratory Syncytial Virus Disease Epidemiology in the United States Prior to the Introduction of Vaccines

Kim

Rha

Abramson

et al. 2017

Clinical Infectious Diseases

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Respiratory syncytial virus (RSV) causes lower respiratory tract illness frequently. No effective antivirals or vaccines for RSV are approved for use in the United States; however, there are at least 50 vaccines and monoclonal antibody products in development, with those targeting older adults and pregnant women (to protect young infants) in phase 2 and 3 clinical trials. Unanswered questions regarding RSV epidemiology need to be identified and addressed prior to RSV vaccine introduction to guide the measurement of impact and future recommendations. The Centers for Disease Control and Prevention (CDC) convened a technical consultation to gather input from external subject matter experts on their individual perspectives regarding evidence gaps in current RSV epidemiology in the United States, potential studies and surveillance platforms needed to fill these gaps, and prioritizing efforts. Participants articulated their individual views, and CDC staff synthesized individuals' input into this report.

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Seasonal Incidence of Medically Attended Respiratory Syncytial Virus Infection in a Community Cohort of Adults ≥50 Years Old

Cited by 65 publications

References 22 publications

Clinical manifestations and outcomes of respiratory syncytial virus infection in adult hospitalized patients

Clinical manifestations and outcomes of respiratory syncytial virus infection in adult hospitalized patients

Clinical Features, Severity, and Incidence of RSV Illness During 12 Consecutive Seasons in a Community Cohort of Adults ≥60 Years Old

Identifying Gaps in Respiratory Syncytial Virus Disease Epidemiology in the United States Prior to the Introduction of Vaccines

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