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. 2017 Apr;23(4):253-259.
doi: 10.1016/j.cmi.2016.11.014. Epub 2016 Nov 27.

Clinical characteristics and outcome of respiratory syncytial virus infection among adults hospitalized with influenza-like illness in France

P Loubet  1 , N Lenzi  2 , M Valette  3 , V Foulongne  4 , A Krivine  5 , N Houhou  6 , G Lagathu  7 , S Rogez  8 , S Alain  9 , X Duval  10 , F Galtier  11 , D Postil  12 , P Tattevin  13 , P Vanhems  14 , F Carrat  15 , B Lina  16 , O Launay  17 ; FLUVAC Study Group
Collaborators, Affiliations

Clinical characteristics and outcome of respiratory syncytial virus infection among adults hospitalized with influenza-like illness in France

P Loubet et al. Clin Microbiol Infect. 2017 Apr.

Abstract

Objectives: The aim of this study was to analyse characteristics and outcome of respiratory syncytial virus (RSV) infection in adults hospitalized with influenza-like illness (ILI).

Methods: Patients hospitalized with ILI were included in this prospective, multicentre study carried out in six French hospitals during three consecutive influenza seasons (2012-2015). RSV and other respiratory viruses were detected by multiplex PCR in nasopharyngeal swabs. Risk factors for RSV infection were identified by backward stepwise logistic regression analysis.

Results: A total of 1452 patients hospitalized with ILI were included, of whom 59% (861/1452) were >65 years and 83% (1211/1452) had underlying chronic illnesses. RSV was detected in 4% (59/1452), and influenza virus in 39% (566/1452). Risk factors for RSV infection were cancer (adjusted OR 2.1, 95% CI 1.1-4.1, p 0.04), and immunosuppressive treatment (adjusted OR 2.0, 95% CI 1.1-3.8, p 0.03). Patients with RSV had a median length of stay of 9 days (6-25), and 57% of them (30/53) had complications, including pneumonia (23/53, 44%) and respiratory failure (15/53, 28%). Fifteen per cent (8/53) were admitted to an intensive care unit, and the in-hospital mortality rate was 8% (4/53). Pneumonia was more likely to occur in patients with RSV than in patients with RSV-negative ILI (44% (23/53) versus 26% (362/1393), p 0.006) or with influenza virus infection (44% versus 28% (157/560), p 0.02).

Conclusion: RSV is an infrequent cause of ILI during periods of influenza virus circulation but can cause severe complications in hospitalized adults. Risk factors for RSV detection in adults hospitalized with ILI include cancer and immunosuppressive treatment. Specific immunization and antiviral therapy might benefit patients at risk.

Keywords: Adults; Elderly; Influenza; Influenza-like illness; Pneumonia; Respiratory syncytial virus.

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Figures

Fig. 1
Fig. 1
Study flowchart.
Fig. 2
Fig. 2
Monthly distribution of respiratory syncytial virus infections in the FLUVAC study.
Fig. 3
Fig. 3
Respiratory syncytial virus and influenza virus circulation in France during the 2012/13 (a), 2013/14 (b) and 2014/15 (c) seasons (data from the GROG, RENAL and Sentinelles surveillance networks) (arrows correspond to the start and end of fluvac study period).
See this image and copyright information in PMC

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