Abstract
Objectives The purpose of this study was to describe the clinical characteristics and in-hospital and post-discharge outcomes of respiratory syncytial virus (RSV) infection among adults hospitalised with influenza-like illness (ILI) and compared against patients admitted for influenza.
Methods Adults hospitalised with ILI were prospectively included from five French university hospitals over two consecutive winter seasons (2017/2018 and 2018/2019). RSV and influenza virus were detected by multiplex reverse transcription PCR on nasopharyngeal swabs. RSV-positive patients were compared to RSV-negative and influenza-positive hospitalised patients. Poisson regression models were used to estimate the adjusted prevalence ratio (aPR) associated with in-hospital and post-discharge outcomes between RSV and influenza infections. The in-hospital outcome was a composite of the occurrence of at least one complication, length of stay ≥7 days, intensive care unit admission, use of mechanical ventilation and in-hospital death. Post-discharge outcome included 30- and 90-day all-cause mortality and 90-day readmission rates.
Results Overall, 1428 hospitalised adults with ILI were included. RSV was detected in 8% (114 of 1428) and influenza virus in 31% (437 of 1428). Patients hospitalised with RSV were older than those with influenza (mean age 73.0 versus 68.8 years, p=0.015) with a higher frequency of chronic respiratory or cardiac disease (52% versus 39%, p=0.012, and 52% versus 41%, p=0.039, respectively) and longer hospitalisation duration (median stay 8 versus 6 days, p<0.001). Anti-influenza therapies were less prescribed among RSV patients than influenza patients (20% versus 66%, p<0.001). In-hospital composite outcome was poorer in RSV patients (aPR 1.5, 95% CI 1.1–2.1) than in those hospitalised with influenza. No difference was observed for the post-discharge composite outcome (aPR 1.1, 95% CI 0.8–1.6).
Conclusion RSV infection results in serious respiratory illness, with worse in-hospital outcomes than influenza and with similar midterm post-discharge outcomes.
Abstract
Respiratory syncytial virus infection in hospitalised adults with influenza-like illness was associated with poor in-hospital and midterm post-discharge outcomes, which may be worse than or similar to those of patients with influenza virus infection https://bit.ly/2VAsMhh
Footnotes
Author contributions: A. Descamps, P. Loubet and O. Launay conceptualised the original study. A. Descamps, P. Loubet and O. Launay developed the methodology. A. Descamps performed the analysis. A. Descamps and P. Loubet wrote the original manuscript. N. Lenzi, F. Galtier, F. Lainé, Z. Lesieur, P. Vanhems, S. Amour, A-S. L'Honneur, N. Fidouh, V. Foulongne, G. Lagathu, X. Duval, C. Merle, B. Lina, F. Carrat and O. Launay critically reviewed the manuscript and agreed to be accountable for all aspects of the work. P. Loubet and O. Launay supervised the research.
Conflict of interest: N. Lenzi has nothing to disclose.
Conflict of interest: F. Galtier has nothing to disclose.
Conflict of interest: F. Lainé has nothing to disclose.
Conflict of interest: Z. Lesieur has nothing to disclose.
Conflict of interest: P. Vanhems reports grants from Pfizer, Sanofi, Anios, MSD and Astellas, outside the submitted work.
Conflict of interest: S. Amour has nothing to disclose.
Conflict of interest: A-S. L'Honneur has nothing to disclose.
Conflict of interest: N. Fidouh has nothing to disclose.
Conflict of interest: V. Foulongne has nothing to disclose.
Conflict of interest: G. Lagathu has nothing to disclose.
Conflict of interest: X. Duval has nothing to disclose.
Conflict of interest: C. Merle has nothing to disclose.
Conflict of interest: B. Lina has nothing to disclose.
Conflict of interest: F. Carrat has nothing to disclose.
Conflict of interest: O. Launay is principal investigator for clinical trials sponsored by Janssen, GSK, Pfizer, Sanofi Pasteur and MSD, outside the submitted work.
Conflict of interest: P. Loubet reports personal fees from Pfizer and non-financial support from Sanofi Pasteur, outside the submitted work.
Conflict of interest: A. Descamps has nothing to disclose.
Support statement: The current work received no funding. However, the study sites received funding from Janssen and Sanofi Pasteur for the FLUVAC study. The funders had no role in considering the choice of research project, design of the study, analyses and interpretation of the data, writing of the report or decision to publish.
- Received March 3, 2021.
- Accepted July 6, 2021.
- Copyright ©The authors 2022. For reproduction rights and permissions contact permissions{at}ersnet.org
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