Abstract
Respiratory syncytial virus (RSV) infection in older adults is recognised, but the burden in the community is still uncertain. This European study found that RSV infection is prevalent but rarely caused severe disease in community-dwelling older adults. https://bit.ly/30gsiMD
Abstract
Background Respiratory syncytial virus (RSV) infection in older adults is recognised as an important health issue. We aimed to assess the community burden of RSV in Europe in older adults aged ≥60 years.
Methods This international, prospective, observational cohort study is part of work by the REspiratory Syncytial virus Consortium in EUrope (RESCEU). Participants were recruited through general practitioners' (GPs) offices before two independent RSV seasons. Participants reported weekly about symptoms of acute respiratory tract infection (ARTI) during one RSV season. ARTI patients were tested for RSV during home visits and completed a daily symptom diary. RSV illness included PCR-confirmed ARTI and those showing seroconversion over the season. RSV ARTI was based on PCR alone (ClinicalTrials.gov, NCT03621930).
Results We recruited 1040 participants (527 in season 2017–2018 and 513 in season 2018–2019) with a median age of 75 years (range 60–100 years). Of these, 1023 (99%) lived independently at home at baseline. RSV illness incidence was 22 out of 527 (4.2%) and 37 out of 513 (7.2%) in the respective seasons. RSV illness did not affect frailty or cardiopulmonary status during the course of the study. No patients were hospitalised or died from RSV illness. In the 36 patients with PCR confirmed RSV ARTI, symptom duration averaged 19 days, while a doctor's visit took place in 11 out of 36 cases (31%). RSV ARTI could not be differentiated clinically from all other ARTIs based on symptoms.
Conclusion This European study showed that RSV is prevalent in community-dwelling older adults and rarely causes severe disease. This suggests that watchful waiting, using a continuity of care approach to identify those who do need more intensive care, is often justified when RSV is suspected in family practice.
Footnotes
This article has supplementary material available from erj.ersjournals.com
This study is registered at ClinicalTrials.gov with identifier number NCT03621930.
RESCEU Investigators: Koos Korsten, Louis Bont and Joanne Wildenbeest (University Medical Centre Utrecht); Niels Adriaenssens, Samuel Coenen and Philippe Beutels (University of Antwerp); Behnaz Ravanfar, Heather Rutter, Julie Allen, Christopher Butler and Andrew Pollard (University of Oxford); Ann Falsey (University of Rochester); Jean-Yves Pirçon, Olivier Gruselle and Amanda Leach (GlaxoSmithKline); Vincent Pavot, Charlotte Vernhes, Clarisse Demont and Scott Gallichan (Sanofi Pasteur); Sunita Balla-Jhagjhoorsingh, Deniz Öner, Jeroen Aerssens and Gabriela Ispas (Janssen); Vivek Shinde and Brian Rosen (Novavax); Theo Verheij (Julius Centrum); Harish Nair and Harry Campbell (University of Edinburgh); Peter Openshaw (Imperial College London); Eva Molero (Team-It Research); Adam Meijer (National Institute for Public Health and the Environment, RIVM, The Netherlands); Thea Kølsen Fischer (Statens Serum Institut); Maarten van den Berge (Academisch Ziekenhuis Groningen); Carlo Giaquinto (Fondazione PENTA for the Treatment and Care of Children with HIV-ONLUS); Michael Abram (AstraZeneca); Kena Swanson (Pfizer).
Author contributions: K. Korsten designed the study, collected the data, drafted the analysis plan, performed the analyses and drafted the manuscript. N. Adriaenssens, B. Ravanfar, H. Rutter and J. Allen were involved in the acquisition of data. S. Coenen, C. Butler, T. Verheij, J-Y. Pirçon, G. Ispas, V. Shinde and A. Falsey advised about the analysis plan and interpretation of the data. O. Gruselle, V. Pavot, C. Vernhes, S. Balla-Jhagjhoorsingh, D. Öner and J. Aerssens provided the laboratory analyses of biomaterials. J. Wildenbeest and L. Bont designed the study, drafted the analysis plan, interpreted the data and led the study. All authors were involved in the analysis plan, critically reviewed the manuscript, and contributed to and approved the final version.
Support statement: The REspiratory Syncytial virus Consortium in EUrope (RESCEU) has received funding from the Innovative Medicines Initiative 2 (IMI-2) Joint Undertaking (grant: 116019). This joint undertaking receives support from the European Union (EU) Horizon 2020 research and innovation programme and the European Federation of Pharmaceutical Industries and Associations (EFPIA). The funders had no role in the design of the study; the collection, analysis, or interpretation of the data; the writing of the manuscript; or the decision to submit the manuscript for publication. Funding information for this article has been deposited with the Crossref Funder Registry.
Conflict of interest: K. Korsten has nothing to disclose.
Conflict of interest: N. Adriaenssens has nothing to disclose.
Conflict of interest: S. Coenen reports grants and non-financial support from European Union (EU) Horizon 2020 research and innovation programme and the European Federation of Pharmaceutical Industries and Associations (EFPIA) Innovative Medicines Initiative 2 (IMI-2) Joint Undertaking (grant: 116019), during the conduct of the study.
Conflict of interest: C. Butler reports grants from the National Institute for Health Research (NIHR) (as NIHR Senior Investigator), grants from the EU Horizon 2020 programme to support the study, grants from the NIHR Health Protection Research Unit on Health Care Associated Infections and Antimicrobial Resistance, grants from the NIHR Health for the MedTech and In Vitro Diagnostics Cooperative for innovative diagnostics and monitoring technology to enhance community healthcare, during the conduct of the study; personal fees for advisory board work from Pfizer and Roche Molecular Systems; and grants from Roche Molecular Diagnostics.
Conflict of interest: B. Ravanfar has nothing to disclose.
Conflict of interest: H. Rutter has nothing to disclose.
Conflict of interest: J. Allen has nothing to disclose.
Conflict of interest: A. Falsey reports grants from Janssen, Merck, Sharpe and Dohme, and Pfizer, as well as non-financial support for meeting attendance from Sanofi Pasteur, outside the submitted work.
Conflict of interest: J-Y. Pirçon is an employee of GlaxoSmithKline Vaccines.
Conflict of interest: O. Gruselle is an employee of GlaxoSmithKline.
Conflict of interest: V. Pavot is an employee of Sanofi Pasteur.
Conflict of interest: C. Vernhes is an employee of Sanofi Pasteur.
Conflict of interest: S. Balla-Jhagjhoorsingh is an employee of Janssen Vaccines & Prevention.
Conflict of interest: D. Öner is an employee of Janssen Pharmaceutica NV and reports grants from the IMI-2 Joint Undertaking (grant: 116019), during the conduct of the study.
Conflict of interest: G. Ispas is an employee of Janssen Pharmaceutica NV.
Conflict of interest: J. Aerssens is an employee of Janssen Pharmaceutica NV.
Conflict of interest: V. Shinde has nothing to disclose.
Conflict of interest: T. Verheij reports grants from Janssen Pharmaceuticals, Becton Dickinson, Abbott and Biomerieux, outside the submitted work.
Conflict of interest: L. Bont has regular interaction with pharmaceutical and other industrial partners. He has not received personal fees or other personal benefits; however, University Medical Center Utrecht has received major funding for investigator-initiated studies from AbbVie, MedImmune, Janssen, the Bill and Melinda Gates Foundation, Nutricia (Danone) and MeMed Diagnostics; has received major cash or in kind funding as part of the public–private partnership, IMI-2 funded REspiratory Syncytial virus Consortium in EUrope (RESCEU) project from GlaxoSmithKline, Novavax, Janssen, AstraZeneca, Pfizer and Sanofi; has received major funding from Julius Clinical for participating in the INFORM study sponsored by MedImmune; has received minor funding for participation in trials by Regeneron and Janssen from 2015–2017; and has received minor funding for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavaria Nordic, MabXience, Novavax, Pfizer and Janssen. L. Bont is also the founding chairman of the ReSViNET Foundation.
Conflict of interest: J. Wildenbeest has nothing to disclose.
- Received April 6, 2020.
- Accepted September 20, 2020.
- Copyright © ERS 2021
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