Adult Respiratory Syncytial Virus Infection: Defining Incidence, Risk Factors for Hospitalization, and Poor Outcomes, a Regional Cohort Study, 2016–2022
Abstract
:1. Introduction
2. Methods
2.1. Study Setting and Design
2.2. Data Sources
2.3. Patients and Definitions
2.4. Statistical Methods
3. Results
3.1. Risk Factors Associated with FLU- and RSV-Positive Hospitalizations
3.2. Risk Factors Associated with Poor Outcomes of an RSV Hospitalization
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Disclaimer
References
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Parameter | All Patients | Good Outcome | Poor Outcome | p Value | |
---|---|---|---|---|---|
n | 942 | 811 (86%) | 131 (14%) | ||
Age, median (IQR) | 72.9 (62.5–81.8) | 72.8 (61.6–81.8) | 73.9 (65.9–81.5) | 0.237 | |
Age group, n (%) | 18–34 | 44 (4.7%) | 43 (5.3%) | 1 (0.8%) | 0.066 |
35–49 | 66 (7.0%) | 60 (7.4%) | 6 (4.6%) | ||
50–64 | 161 (17.1%) | 139 (17.1%) | 22 (16.8%) | ||
≥65 | 671 (71.2%) | 569 (70.2%) | 102 (77.9%) | ||
Female sex, n (%) | 546 (58.0%) | 477 (58.8%) | 69 (52.7%) | 0.22 | |
Hospital, n (%) | SUMC | 780 (82.8%) | 678 (83.6%) | 102 (77.9%) | 0.136 |
AAUH | 162 (17.2%) | 133 (16.4%) | 29 (22.1%) | ||
Comorbidities | Cardiovascular disease, n (%) | 201 (21.3%) | 170 (21.0%) | 31 (23.7%) | 0.558 |
Cerebrovascular accident, n (%) | 57 (6.1%) | 48 (5.9%) | 9 (6.9%) | 0.821 | |
Pulmonary disease, n (%) | 178 (18.9%) | 148 (18.2%) | 30 (22.9%) | 0.254 | |
Diabetes mellitus, n (%) | 327 (34.7%) | 269 (33.2%) | 58 (44.3%) | 0.017 | |
Chronic renal failure, n (%) | 158 (16.8%) | 122 (15.0%) | 36 (27.5%) | 0.001 | |
Clinical presentation at ED | Fever, n (%) | 229 (26.9) | 206 (27.7) | 23 (21.5) | 0.214 |
Hypoxemia, n (%) | 318 (37.7) | 268 (36.5) | 50 (45.5) | 0.089 | |
WBC, cells/μL, median (IQR) | 8.6 (6.5–11.6) | 8.4 (6.5–11.3) | 9.9 (6.3–14.8) | 0.016 | |
WBC grouping | Normal, n (%) | 566 (60.1%) | 504 (62.1%) | 62 (47.3%) | 0.004 |
Low, n (%) | 88 (9.3%) | 74 (9.1%) | 14 (10.7%) | ||
High, n (%) | 288 (30.6%) | 233 (28.7%) | 55 (42.0%) | ||
Neutrophils, cells/μL, median (IQR) | 6.6 (4.5–9.6) | 6.4 (4.5–9.3) | 8.0 (4.6–12.7) | 0.002 | |
Neutrophil grouping | Normal, n (%) | 499 (53.0%) | 447 (55.1%) | 52 (39.7%) | 0.002 |
Low, n (%) | 28 (3.0%) | 21 (2.6%) | 7 (5.3%) | ||
High, n (%) | 415 (44.1%) | 343 (42.3%) | 72 (55.0%) | ||
Lymphocytes, cells/μL, median (IQR) | 1.1 (0.7–1.6) | 1.1 (0.7–1.6) | 0.9 (0.50–1.4) | 0.002 | |
Lymphocyte grouping | Normal, n (%) | 500 (53.1%) | 444 (54.7%) | 56 (42.7%) | 0.026 |
Low, n (%) | 435 (46.2%) | 362 (44.6%) | 73 (55.7%) | ||
High, n (%) | 7 (0.7%) | 5 (0.6%) | 2 (1.5%) | ||
C-reactive protein grouping | <50 mg/L | 387 (51.5%) | 338 (53.1%) | 49 (42.6%) | 0.017 |
50–100 mg/dL | 170 (22.6%) | 146 (22.9%) | 24 (20.9%) | ||
>100 mg/dL | 195 (25.9%) | 153 (24.0%) | 42 (36.5%) | ||
Antimicrobial treatment, n (%) | Before PCR results | 418 (44.8%) | 345 (42.8%) | 73 (57.5%) | 0.003 |
After PCR results | 260 (27.8%) | 192 (23.8%) | 68 (53.5%) | <0.001 | |
ICU admission, n (%) | 37 (3.9%) | 0 (0.0%) | 37 (28.2%) | ||
Mechanical ventilation, n (%) | 36 (3.8%) | 0 (0%) | 36 (27/5%) | ||
In-hospital death, n (%) | 59 (15.1%) | 0 (0.0%) | 59 (45.0%) | ||
Length of stay, days, mean (SD) | 5.9 (10.8) | 4.5 (8.4) | 14.9 (17.5) | <0.001 | |
Length of stay <3 days, n (%) | 573 (60.8%) | 544 (67.1%) | 29 (22.1%) | <0.001 | |
Rehospitalization within 30 days, n (%) | 84 (8.9%) | 67 (8.3%) | 17 (13.0%) | 0.111 |
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Brosh-Nissimov, T.; Ostrovsky, D.; Cahan, A.; Maaravi, N.; Leshin-Carmel, D.; Burrack, N.; Gorfinkel, R.; Nesher, L. Adult Respiratory Syncytial Virus Infection: Defining Incidence, Risk Factors for Hospitalization, and Poor Outcomes, a Regional Cohort Study, 2016–2022. Pathogens 2024, 13, 750. https://doi.org/10.3390/pathogens13090750
Brosh-Nissimov T, Ostrovsky D, Cahan A, Maaravi N, Leshin-Carmel D, Burrack N, Gorfinkel R, Nesher L. Adult Respiratory Syncytial Virus Infection: Defining Incidence, Risk Factors for Hospitalization, and Poor Outcomes, a Regional Cohort Study, 2016–2022. Pathogens. 2024; 13(9):750. https://doi.org/10.3390/pathogens13090750
Chicago/Turabian StyleBrosh-Nissimov, Tal, Daniel Ostrovsky, Amos Cahan, Nir Maaravi, Daniel Leshin-Carmel, Nitzan Burrack, Rotem Gorfinkel, and Lior Nesher. 2024. "Adult Respiratory Syncytial Virus Infection: Defining Incidence, Risk Factors for Hospitalization, and Poor Outcomes, a Regional Cohort Study, 2016–2022" Pathogens 13, no. 9: 750. https://doi.org/10.3390/pathogens13090750