Epidemiology, clinical features, and resource utilization associated with respiratory syncytial virus in the community and hospital
Open Access
- 20 February 2020
- journal article
- research article
- Published by Wiley in Influenza and Other Respiratory Viruses
- Vol. 14 (3), 247-256
- https://doi.org/10.1111/irv.12723
Abstract
Background The epidemiology, clinical features, and resource utilization of respiratory syncytial virus (RSV) cases in the community and the hospital are not fully characterized. Methods We identified individuals of all ages with laboratory‐confirmed RSV from two sources, a community cohort undergoing surveillance for acute respiratory infections (ARIs) and hospitalized patients from the same geographic area of New York City between 2013 and 15. The epidemiology, clinical features, and resource utilization (antibiotic/steroid/ribavirin usage, chest X‐rays, respiratory‐support (continuous positive airway pressure [CPAP], mechanical ventilation or extracorporeal membrane oxygenation [ECMO]), and indicators of disease severity (respiratory‐support, and/or ICU admission or death)) were compared among age groups using univariate and bivariate analyses. Results In the community cohort (1777 people with 1805 ARIs), 66(3.7%) tested RSV‐positive (3.8% of <1‐year‐olds; 3.8% of adults ≥65); 40.9% were medically attended, and 23.1% reported antibiotic usage. Among 40,461 tests performed on hospital patients, 2.7% were RSV‐positive within ± 2 days of admission (37.3% <1 year old; 17.4% ≥65 years old). Among RSV‐positive hospitalized adults ≥65%, 92.7%, 89.6% and 78.1% received a chest X‐ray, antibiotics and/or steroids respectively, compared with 48.9%, 45.7%, and 48.7% of children <1. Severe illness occurred in 27.0% RSV‐positive hospitalized <1‐year‐olds and 19.8% ≥65‐year‐olds. Conclusions Respiratory syncytial virus had a demonstrated impact in the community and hospital. Only 40% of RSV community cases were medically attended. In the hospitalized‐cohort, <1‐ and ≥ 65‐year‐olds accounted for the majority of patients and had similar rates of severe illness. In addition, resource utilization was high in older adults, making both young children and older adults important potential RSV vaccine targets.Keywords
Funding Information
- National Center for Immunization and Respiratory Diseases (U01IP000618)
This publication has 25 references indexed in Scilit:
- Respiratory Syncytial Virus and Other Respiratory Viral Infections in Older Adults With Moderate to Severe Influenza-like IllnessThe Journal of Infectious Diseases, 2014
- Practical approach to management of respiratory complications in neurological disordersInternational Journal of General Medicine, 2012
- Children With Complex Chronic Conditions in Inpatient Hospital Settings in the United StatesPEDIATRICS, 2010
- The Burden of Respiratory Syncytial Virus Infection in Young ChildrenThe New England Journal of Medicine, 2009
- Respiratory Syncytial Virus Infection in Elderly and High-Risk AdultsThe New England Journal of Medicine, 2005
- Economic Impact of Respiratory Syncytial Virus-Related Illness in the USPharmacoEconomics, 2004
- Winter Respiratory Viruses and Health Care Use: A Population-Based Study in the Northwest United StatesClinical Infectious Diseases, 2003
- Mortality Associated With Influenza and Respiratory Syncytial Virus in the United StatesJAMA, 2003
- Rates of hospitalization for respiratory syncytial virus infection among children in MedicaidThe Journal of Pediatrics, 2000
- Respiratory Syncytial Virus Infection in AdultsClinical Microbiology Reviews, 2000