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Zhang Y, Wang Y, Zhao J, Xiong Z, Fan Y, Zhang W, Zou X, Wang C, Han J, Li B, Lu B, Cao B. Severity and mortality of respiratory syncytial virus vs influenza A infection in hospitalized adults in China. Influenza Other Respir Viruses 2020; 14:483-490. [PMID: 32449300 PMCID: PMC7431648 DOI: 10.1111/irv.12754] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 12/24/2022] Open
Abstract
Background Respiratory syncytial virus (RSV) is an important cause of medically attended acute respiratory illnesses in older adults but awareness of the relevance of RSV in older people remains lower than that of influenza, which exhibits similar clinical characteristics to those of RSV. Objectives This study was performed to assess the clinical significance of RSV in respiratory samples from hospitalized adults. Methods Characteristics and outcomes in adults (≥18 years) hospitalized for RSV infection (n = 51) were compared with a cohort hospitalized for influenza A infection (n = 279) in a single‐center retrospective cohort study in Beijing, China. Results Respiratory syncytial virus patients were slightly older, with no significant differences in underlying chronic conditions. Lower respiratory tract infection and cardiovascular complications were more frequent (P < .05) in RSV patients. Rates of mortality in the RSV cohorts were significantly higher within 30 days (13.7% vs 5.0%, P = .019) and 60 days (17.6% vs 7.5%, P = .021). Bacterial co‐infection in respiratory samples was associated with reduced survival among RSV patients (log rank, P = .013). Conclusions Respiratory syncytial virus is a common cause of serious illness among hospitalized adults in China with greater mortality than influenza A. Increased awareness and the availability of antiviral agents might increase the scope for successful management.
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Affiliation(s)
- Yulin Zhang
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Yeming Wang
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Jiankang Zhao
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Zhujia Xiong
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Yanyan Fan
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Wang Zhang
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Xiaohui Zou
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Chunlei Wang
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Jiajing Han
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Binbin Li
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | | | - Bin Cao
- Department of Pulmonary and Critical Care Medicine, Laboratory of Clinical Microbiology and Infectious Diseases, Center for Respiratory Diseases, National Clinical Research Center of Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China.,Clinical Center for Pulmonary Infections, Capital Medical University, Beijing, China.,Tsinghua University-Peking University Joint Center for Life Sciences, Beijing, China
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Kieke BA, Belongia EA, McClure DL, Shinde V. Prediction of serious RSV-related outcomes in older adults with outpatient RSV respiratory illness during 12 consecutive seasons. Influenza Other Respir Viruses 2020; 14:479-482. [PMID: 32390298 PMCID: PMC7431638 DOI: 10.1111/irv.12751] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 01/28/2020] [Accepted: 04/16/2020] [Indexed: 11/29/2022] Open
Abstract
We developed and evaluated a model to predict serious outcomes among 243 adults ≥60 years old with medically attended respiratory illness and laboratory‐confirmed respiratory syncytial virus (RSV); 47 patients had a serious outcome defined as hospital admission, emergency department (ED) visit, or pneumonia diagnosis. The model used logistic regression with penalized maximum likelihood estimation. The reduced penalized model included age ≥ 75 years, ≥1 ED visit in prior year, crackles/rales, tachypnea, wheezing, new/increased sputum, and new/increased dyspnea. The optimal score cutoff yielded sensitivity and specificity of 66.0% and 81.6%. This prediction model provided moderate utility for identifying older adults with elevated risk of complicated RSV illness.
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Affiliation(s)
- Burney A Kieke
- Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
| | | | - David L McClure
- Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
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53
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Bruyndonckx R, Coenen S, Butler C, Verheij T, Little P, Hens N, Beutels P, Ieven M, Goossens H. Respiratory syncytial virus and influenza virus infection in adult primary care patients: Association of age with prevalence, diagnostic features and illness course. Int J Infect Dis 2020; 95:384-390. [PMID: 32320810 PMCID: PMC7167228 DOI: 10.1016/j.ijid.2020.04.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 02/05/2023] Open
Abstract
RSV prevalence in patients age 75+ was twice the prevalence in those under 60. Influenza prevalence is not associated with age. Diagnostics are not associated with age for RSV and influenza. Illness course is associated with age for both RSV and influenza.
Objectives To better target new vaccines and treatments being developed for respiratory syncytial virus (RSV) and influenza virus (influenza), we studied the association of age with prevalence, diagnostic features and course of illness of these infections in primary care patients. Methods Secondary analysis of observational data on the aetiology, diagnosis and prognosis in adults presenting to primary care with acute cough in 12 European countries (2007–2010) using regression analyses corrected for clustering of patients within countries. Age groups were 18–59 years, 60–74 years, and 75 years and older (75+). Results Nasopharyngeal swabs for 144 (4.6%), 169 (5.4%) and 104 (3.4%) out of 3104 patients were polymerase chain reaction (PCR) positive for RSV, influenza A and influenza B, respectively. RSV prevalence in patients 75+ (8.5%) was twice the prevalence in those under 60 years (4.2%). Influenza prevalence was not associated with age. Diagnostic features for these viruses were not associated with age. Symptom duration was associated with age for RSV and influenza B, but not for influenza A. The odds of unresolved symptoms after 28 days were associated with age for RSV only. Illness deterioration was associated with age for RSV, with patients 75+ at increased risk, but not for influenza. Conclusion In adults presenting to primary care with acute cough, the diagnostic features of RSV or influenza infection are not associated with age. For RSV both the prevalence and illness course are significantly worse at higher age, for influenza only the illness course is.
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Affiliation(s)
- Robin Bruyndonckx
- Data Science Institute (DSI), Hasselt University, Hasselt, Belgium; Laboratory of Medical Microbiology, Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium.
| | - Samuel Coenen
- Laboratory of Medical Microbiology, Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium; Department of Epidemiology and Social Medicine (ESOC), University of Antwerp, Antwerp, Belgium; Department of Primary and Interdisciplinary Care (ELIZA), University of Antwerp, Antwerp, Belgium
| | - Chris Butler
- Institute for Primary Care and Public Health, Cardiff University, Cardiff, UK
| | - Theo Verheij
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Paul Little
- Aldermoor Health Centre, University of Southampton, Southampton, UK
| | - Niel Hens
- Data Science Institute (DSI), Hasselt University, Hasselt, Belgium; Centre for Health Economic Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Philippe Beutels
- Centre for Health Economic Research and Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Margareta Ieven
- Laboratory of Medical Microbiology, Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
| | - Herman Goossens
- Laboratory of Medical Microbiology, Vaccine & Infectious Diseases Institute (VAXINFECTIO), University of Antwerp, Antwerp, Belgium
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Chadha M, Hirve S, Bancej C, Barr I, Baumeister E, Caetano B, Chittaganpitch M, Darmaa B, Ellis J, Fasce R, Kadjo H, Jackson S, Leung V, Pisareva M, Moyes J, Naguib A, Tivane A, Zhang W. Human respiratory syncytial virus and influenza seasonality patterns-Early findings from the WHO global respiratory syncytial virus surveillance. Influenza Other Respir Viruses 2020; 14:638-646. [PMID: 32163226 PMCID: PMC7578323 DOI: 10.1111/irv.12726] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Accepted: 01/13/2020] [Indexed: 12/14/2022] Open
Abstract
Background Human respiratory syncytial virus (RSV) causes illnesses among all age groups and presents a burden to healthcare services. To better understand the epidemiology and seasonality of RSV in different geographical areas, the World Health Organization (WHO) coordinated a pilot initiative to access the feasibility of establishing RSV surveillance using the existing Global Influenza Surveillance and Response System (GISRS) platform. Objectives To describe and compare RSV and influenza seasonality in countries in the northern andsouthern temperate, and tropics during the period January 2017 to April 2019. Methods Fourteen countries in six WHO regions participating in the GISRS were invited for the pilot. Hospitalized patients presenting with severe acute respiratory illness (SARI), SARI without fever and outpatients presenting with acute respiratory illness (ARI) were enrolled from January 2017 to April 2019. The expected minimum sample size was 20 samples per week, year‐round, per country. Real‐time RT‐PCR was used to detect RSV and influenza viruses. Results were uploaded to the WHO FluMart platform. Results Annual seasonality of RSV was observed in all countries, which overlapped to a large extent with the influenza activity. In countries, in temperate regions RSV peaked in the autumn/winter months. In Egypt, a subtropical country, RSV activity peaked in the cooler season. In the tropical regions, RSV peaked during the rainy seasons. Conclusion Early findings from the WHO RSV surveillance pilot based on the GISRS suggest annual seasonal patterns for of RSV circulation that overlap with influenza. RSV surveillance needs to be continued for several more seasons to establish seasonality patterns to inform prevention and control strategies.
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Affiliation(s)
- Mandeep Chadha
- National Institute of Virology, Indian Council of Medical Research, Pune, India
| | | | - Christina Bancej
- Centre for Immunization and Respiratory Infections, Public Health Agency of Canada, Ottawa, Canada
| | - Ian Barr
- Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Elsa Baumeister
- Departamento Virologia, INEI-ANLIS "Carlos G Malbrán", Buenos Aires, Argentina
| | | | | | - Badarch Darmaa
- Virology Laboratory, National Center for Communicable Diseases, Ulan baatar, Mongolia
| | - Joanna Ellis
- Virus Reference Department, Public Health England, London, United Kingdom
| | - Rodrigo Fasce
- Sub-department of Viral Diseases, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Herve Kadjo
- Department of Epidemic Viruses, Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Sandra Jackson
- Global Influenza Programme, World Health Organization, Geneva, Switzerland
| | - Vivian Leung
- Victorian Infectious Diseases Reference Laboratory, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - Maria Pisareva
- Laboratory of Molecular Virology, Smorodintsev Research Institute of Influenza, St. Petersburg, Russian Federation
| | - Jocelyn Moyes
- Center for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - Amel Naguib
- Central Public Health Laboratory, Ministry of Health, Cairo, Egypt
| | - Almiro Tivane
- Laboratório de Isolamento Viral, Instituto Nacional de Saúde, Maputo, Mozambique
| | - Wenqing Zhang
- Global Influenza Programme, World Health Organization, Geneva, Switzerland
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Abstract
Respiratory syncytial virus (RSV) is the most common pathogen associated with acute lower respiratory tract infections in young children. RSV is also a major viral pathogen causing severe lung disease in the adult population, particularly among the elderly. We conducted a review of adult RSV studies published from January 1970 to February 2017 to determine the burden of disease among adults worldwide. There were no restrictions on health care setting or definition of RSV infection. A total of 1530 published studies were identified, 95 of which were included in this review. The incidence rates of hospitalised RSV acute respiratory tract infection (ARI) in adults >65 years old ranged from 7.3 to 13.0/105 population in Africa and Asia and from 190 to 254/105 population in the USA. Higher incidence rates (195–1790/105 population) were observed in adults ≥50 years old for outpatient or emergency visits in the USA. Of all ARI patients, RSV accounted for 1–10% in adults and 2–14% in patients with chronic diseases or transplantation. Given the limitations in the existing data, significant efforts should be made to generate evidence on the burden of RSV infections in adults and to estimate the potential impact of future preventive interventions.
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Ali A, Lopardo G, Scarpellini B, Stein RT, Ribeiro D. Systematic review on respiratory syncytial virus epidemiology in adults and the elderly in Latin America. Int J Infect Dis 2020; 90:170-180. [PMID: 31669592 PMCID: PMC7110494 DOI: 10.1016/j.ijid.2019.10.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/17/2019] [Accepted: 10/18/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES The present study provides a comprehensive review of the recently published data on RSV epidemiology in adults and the elderly in Latin America. METHODS A systematic literature search was carried out in Medline, Scielo, Lilacs, and Cochrane Library. The search strategy aimed at retrieving studies focusing on RSV prevalence, burden, risk factors, and the routine clinical practice in the prevention and management of RSV infections in Latin American countries. Only articles published between January 2011 and December 2017 were considered. RESULTS Eighteen studies were included. Percentages of RSV detection varied highly across included studies for adult subjects with respiratory infections (0% to 77.9%), influenza-like illness (1.0% to 16.4%) and community-acquired pneumonia (1.3% to 13.5%). Considerable percentages of hospitalization were reported for RSV-infected adults with influenza-like illness (40.9% and 69.9%) and community-acquired pneumonia (91.7%). CONCLUSIONS Recent RSV data regarding adult populations in Latin America are scarce. RSV was documented as a cause of illness in adults and the elderly, being identified in patients with acute respiratory infections, influenza-like illness and community-acquired pneumonia. The studies suggest that RSV infections may be a significant cause of hospitalization in adult populations in Latin America, including younger adults.
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Affiliation(s)
- Abraham Ali
- Fundación Neumológica Colombiana, Carrera 13B # 161- 85 Piso 2, Postal Code 110131, Bogotá, Colombia.
| | - Gustavo Lopardo
- Department of Infectious Diseases at FUNCEI and Hospital Bernardo Houssay, French 3085, (1425) Buenos Aires, Argentina.
| | - Bruno Scarpellini
- Real World Evidence Department, Medical Affairs Latin America, Janssen Cilag Farmacêutica, Avenida Presidente Juscelino Kubitschek, 2041 - Vila Nova Conceição, 04543-011, São Paulo, Brazil.
| | - Renato T. Stein
- Pontifícia Universidade Católica do RGS (PUCRS), ReSViNET Executive Committee member, Centro Clinico PUCRS, Av. Ipiranga, 6690, conj.420. Porto Alegre, RS, CEP 90610-000, Brazil
| | - Diogo Ribeiro
- CTI Clinical Trial & Consulting Services, Rua Tierno Galvan, Torre 3, Piso 16, 1070-274 Lisboa, Portugal.
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Detection of Common Respiratory Viruses in Patients with Acute Respiratory Infections Using Multiplex Real-Time RT-PCR. Jundishapur J Microbiol 2019. [DOI: 10.5812/jjm.96513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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