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. 2017 Nov:96:37-43.
doi: 10.1016/j.jcv.2017.09.001. Epub 2017 Sep 7.

Respiratory syncytial virus hospitalization in middle-aged and older adults

Ryan E Malosh  1 , Emily T Martin  2 , Amy P Callear  3 , Joshua G Petrie  3 , Adam S Lauring  4 , Lois Lamerato  5 , Alicia M Fry  6 , Jill Ferdinands  6 , Brendan Flannery  5 , Arnold S Monto  3
Affiliations

Respiratory syncytial virus hospitalization in middle-aged and older adults

Ryan E Malosh et al. J Clin Virol. 2017 Nov.

Abstract

Background: The importance of Respiratory Syncytial Virus (RSV) is increasingly recognized in hospitalized adults, but mainly in those ≥ 65 years.

Objectives: We sought to describe the epidemiology and clinical severity of RSV compared to influenza in hospitalized adults ≥18 years.

Study design: Adults hospitalized with acute respiratory illnesses (ARI) of ≤10days duration were prospectively enrolled from two Michigan hospitals during two influenza seasons. Collected specimens were tested for RSV and influenza by real-time, reverse transcription polymerase chain reaction (RT-PCR). Viral load and subtype were determined for RSV-positive specimens. We evaluated factors associated with RSV and outcomes of infection using multivariable logistic regression. RSV-positive patients were separately compared to two reference groups: RSV-negative and influenza-negative, and influenza-positive patients.

Results: RSV was detected in 84 (7%) of 1259 hospitalized individuals (55 RSV-B, 29 RSV-A). The highest prevalence was found in 50-64year olds (40/460; 8.7%); 98% of RSV cases in this age group had at least one chronic comorbidity. RSV detection was associated with obesity (OR: 1.71 95% CI: 0.99-3.06, p=0.03). Individuals with RSV were admitted to the hospital later in their illness and had a higher median Charlson comborbidity index (3 vs 2 p<0.001) compared to those with influenza. Clinical severity of RSV-associated hospitalizations was similar to influenza-associated hospitalizations.

Discussion: In this study we observed the highest frequency of RSV-associated hospitalizations among adult 50-64 years old; many of whom had chronic comorbidities. Our results suggest the potential benefit of including these individuals in future RSV vaccination strategies.

Keywords: Adults; Hospitalization; Influenza; RSV; acute respiratory illness.

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Figures

Figure 1
Figure 1. Respiratory Syncytial Virus (RSV) and influenza detections and total number of specimens collected in adults hospitalized with acute respiratory illness (ARI) over two seasons
a 2014-2015 season: 62 RSV positive specimens, 11 RSV-A and 50 RSV-B. 136 Influenza positive specimens, 116 (85%) influenza A/H3N2. One individual was coinfected with RSV-B and unsubtypeable influenza A and was excluded from further analyses. b 2015-2016 season: 25 total RSV positive specimens, 19 RSV-A and 6 RSV-B. 100 influenza positive specimens, 89 (89%) influenza A/H1N1. One individual in 2015-2016 was coinfected with RSV-A and influenza A/H1 and was excluded from further analyses.
See this image and copyright information in PMC

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