TY - JOUR T1 - Burden of respiratory syncytial virus infection in community-dwelling older adults in Europe (RESCEU): an international prospective cohort study JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.02688-2020 SP - 2002688 AU - Koos Korsten AU - Niels Adriaenssens AU - Samuel Coenen AU - Christopher Butler AU - Behnaz Ravanfar AU - Heather Rutter AU - Julie Allen AU - Ann Falsey AU - Jean-Yves Pirçon AU - Olivier Gruselle AU - Vincent Pavot AU - Charlotte Vernhes AU - Sunita Balla-Jhagjhoorsingh AU - Deniz Öner AU - Gabriela Ispas AU - Jeroen Aerssens AU - Vivek Shinde AU - Theo Verheij AU - Louis Bont AU - Joanne Wildenbeest A2 - , Y1 - 2020/01/01 UR - http://erj.ersjournals.com/content/early/2020/09/25/13993003.02688-2020.abstract N2 - Background Respiratory syncytial virus (RSV) infection in older adults is recognized 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 REspiratory Syncytial virus Consortium in EUrope (RESCEU). Participants were recruited before two independent RSV-seasons through general practitioner's offices. 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, 513 in season 2018–2019) with a median age of 75 years (range 60–100). 1023 (99%) lived independently at home at baseline. RSV-illness incidence was 4.2% (22/527) and 7.2% (37/513) in the respective seasons. RSV-illness did not affect frailty or cardiopulmonary status during the course of the study. No patients were hospitalized 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 11/36 (31%) of cases. RSV-ARTI could not clinically be differentiated from all other ARTI 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.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. ADRIAENSSENS has nothing to disclose.Conflict of interest: Dr. AERSSENS reports personal fees from Janssen Pharmaceutica NV, during the conduct of the study; .Conflict of interest: Mrs. Allen has nothing to disclose.Conflict of interest: Dr. Sunita Balla-Jhagjhoorsingh reports personal fees from Janssen Vaccines & Prevention during the conduct of the study.Conflict of interest: Dr. Bont reports and Dr. Bont has regular interaction with pharmaceutical and other industrial partners. He has not received personal fees or other personal benefits. UMCU has received major funding (<€100,000 per industrial partner) for investigator initiated studies from AbbVie, MedImmune, Janssen, the Bill and Melinda Gates Foundation, Nutricia (Danone) and MeMed Diagnostics. UMCU has received major cash or in kind funding as part of the public private partnership IMI-funded RESCEU project from GSK, Novavax, Janssen, AstraZeneca, Pfizer and Sanofi. UMCU has received major funding by Julius Clinical for participating in the INFORM study sponsored by MedImmune. UMCU has received minor funding for participation in trials by Regeneron and Janssen from 2015-2017 (total annual estimate less than €20,000). UMCU received minor funding for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavaria Nordic, MabXience, Novavax, Pfizer, Janssen (total annual estimate less than €20,000). Dr. Bont is the founding chairman of the ReSViNET Foundation.Conflict of interest: Dr. Butler reports grants from National Institute for Health Research Health as NIHR Senior Investigator, grants from the EU IMI to support the study, grants from the National Institute for Health Research Health Protection Research Unit on Health Care Associated Infections and Antimicrobial Resistance, grants from National Institute for the Health Research 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 from Pfizer and Roche Molecular Systems, grants from Roche Molecular Diagnostics.Conflict of interest: Dr. Falsey reports grants from Janssen , grants from Merck, Sharpe and Dohme, grants from Pfizer, non-financial support from Sanofi pasteur, outside the submitted work; .Conflict of interest: Dr. Gruselle reports personal fees from GSK, during the conduct of the study; .Conflict of interest: Dr. Ispas reports personal fees from Janssen Pharmaceutica NV, during the conduct of the study; .Conflict of interest: Dr. Korsten has nothing to disclose.Conflict of interest: Dr. Öner reports personal fees from Janssen Pharmaceutica NV, grants from Innovative Medicines Initiative 2 Joint Undertaking (IMI-2), during the conduct of the study; .Conflict of interest: Dr. Vincent PAVOT reports personal fees from Sanofi Pasteur, during the conduct of the study.Conflict of interest: Dr. Pirçon reports personal fees from GSK Vaccines, during the conduct of the study; personal fees from GSK Vaccines, outside the submitted work; .Conflict of interest: Dr. Ravanfar has nothing to disclose.Conflict of interest: Mrs. Rutter has nothing to disclose.Conflict of interest: Dr. Shinde has nothing to disclose.Conflict of interest: Dr. Verheij reports grants from Janssen Pharmaceuticals, grants from Becton Dickinson, Abbott, Biomerieux, outside the submitted work; .Conflict of interest: Charlotte Vernhes reports personal fees from Sanofi Pasteur , during the conduct of the study;.Conflict of interest: Dr. Wildenbeest has nothing to disclose.Conflict of interest: Dr. Coenen reports grants and non-financial support from European Union's Horizon 2020 research and innovation programme and theEuropean Federation of Pharmaceutical Industries and Associations (EFPIA)., during the conduct of the study;. ER -