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. 2022 Nov;16(6):1151-1160.
doi: 10.1111/irv.13043. Epub 2022 Sep 7.

Change in functional status associated with respiratory syncytial virus infection in hospitalized older adults

Angela R Branche  1 , Lisa Saiman  2   3 , Edward E Walsh  1   4 , Ann R Falsey  1   4 , Haomiao Jia  5 , Angela Barrett  2 , Luis Alba  2 , Matthew Phillips  6 , Lyn Finelli  6
Affiliations

Change in functional status associated with respiratory syncytial virus infection in hospitalized older adults

Angela R Branche et al. Influenza Other Respir Viruses. 2022 Nov.

Abstract

Background: Respiratory syncytial virus (RSV) causes severe respiratory illnesses in infants and older adults. Older adults are frequently hospitalized with RSV illness and may experience loss of function. This study evaluated longitudinal changes in function associated with RSV hospitalization in older adults.

Methods: Adults ≥60 years hospitalized with laboratory-confirmed RSV were enrolled (N = 302). Demographics and comorbidities were collected. Functional status was assessed 2 weeks pre-hospitalization by recall, at enrollment, hospital discharge and 2, 4, and 6 months post-discharge using the Lawton-Brody Instrumental Activities of Daily Living (IADL) (scale 0-8) and Barthel ADL Index (scale 0-100).

Results: RSV-associated hospitalization resulted in acute functional loss. Median IADL (5 vs. 3, p < 0.0001) and ADL (90 vs. 70, p < 0.0001) scores decreased significantly from pre-hospitalization to admission and remained decreased at discharge. There were no statistically significant differences between pre-hospitalization and 2-, 4-, or 6-month scores. However, 33% and 32% of subjects experienced decreased 6-month IADL and ADL scores, respectively. Additionally, 14% required a higher level of care at discharge. When stratified by pre-hospitalization living situation, 6-month IADL scores declined significantly for those admitted from a skilled nursing facility (3 vs. 1, p = 0.001). In multivariate analysis, male sex and diabetes were associated with a 6-month decline in ADL score of ≥10.

Conclusions: Older adults hospitalized with RSV demonstrate acute functional decline that may become prolonged. Pre-hospitalization living situation may predict patient outcomes. Further study is needed with hospitalized age-matched controls and refined measurement tools to better define the specific impact of RSV on function.

Keywords: activities of daily living; adults; functional status; respiratory syncytial virus.

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Conflict of interest statement

LF and MP are employees of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA. LS served on an advisory board and serves on a data safety monitory board (DSMB) for Merck & Co., Inc., Kenilworth, NJ, USA. ARB, LS, ARF, and EEW received grant funding from Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA, to perform this work. ARB has research grants from Pfizer, Janssen, and CyanVac. EEW has research grants from Janssen and Pfizer and served on a DSMB sponsored by GlaxoSmithKline and advisory board for Gilead, Inc. ARF has research grants from Pfizer, Janssen, CyanVac, and BioFire Diagnostics and serves on the DSMB for Novavax.

Figures

FIGURE 1
FIGURE 1
Graphic display of enrollment strategy and results for the study population
FIGURE 2
FIGURE 2
Change in functional status in adults ≥60 year of age at pre‐hospitalization and 2, 4, and 6 months after RSV hospitalization for (A) the Barthel Index of Activities of Daily Living (ADL) and (B) the Lawton Brody Instrumental Activities of Daily. Each panel shows data for baseline.
See this image and copyright information in PMC

References

    1. Falsey AR, Hennessey PA, Formica MA, Cox C, Walsh EE. Respiratory syncytial virus infection in elderly and high‐risk adults. N Engl J Med. 2005;352(17):1749‐1759. doi:10.1056/NEJMoa043951 - DOI - PubMed
    1. McClure DL, Kieke BA, Sundaram ME, et al. Seasonal incidence of medically attended respiratory syncytial virus infection in a community cohort of adults >/=50 years old. PLoS One. 2014;9(7):e102586. doi:10.1371/journal.pone.0102586 - DOI - PMC - PubMed
    1. Matias G, Taylor R, Haguinet F, Schuck‐Paim C, Lustig R, Shinde V. Estimates of mortality attributable to influenza and RSV in the United States during 1997‐2009 by influenza type or subtype, age, cause of death, and risk status. Influenza Other Respi Viruses. 2014;8(5):507‐515. doi:10.1111/irv.12258 - DOI - PMC - PubMed
    1. Thompson WW, Shay DK, Weintraub E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. Jama. 2003;289(2):179‐186. doi:10.1001/jama.289.2.179 - DOI - PubMed
    1. Falsey AR, McElhaney JE, Beran J, et al. Respiratory syncytial virus and other respiratory viral infections in older adults with moderate to severe influenza‐like illness. J Infect Dis. 2014;209(12):1873‐1881. doi:10.1093/infdis/jit839 - DOI - PMC - PubMed

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