Severity of respiratory syncytial virus compared with SARS-CoV-2 and influenza among hospitalised adults ≥65 years - 17/10/24
, Silvia Galindo Carretero a, José Luis Mayordomo b, Mercedes Belén Rumayor Zarzuelo c, Virginia Álvarez Río d, Virtudes Gallardo García e, Miriam García Vázquez f, María del Carmen García Rodríguez g, Luca Basile h, Nieves López González-Coviella i, Maria Isabel Barranco Boada j, Olaia Pérez-Martínez k, Ana Lameiras Azevedo l, Carmen Quiñones Rubio m, Jaume Giménez Duran n, o, Ana Fernández Ibáñez p, María Victoria García Rivera q, Violeta Ramos Marín r, Daniel Castrillejo s, Luis Javier Viloria Raymundo t, Amparo Larrauri a, u, Susana Monge a, vthe SARI Sentinel Surveillance Group1
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Summary |
Introduction |
Our aim was to estimate the risk of pneumonia, admission to intensive care unit (ICU) or death in individuals ≥65 years old admitted to hospital with RSV, compared to influenza or COVID-19.
Methods |
We included hospitalised patients from Severe Acute Respiratory Infection Surveillance in Spain between 2021–2024, aged ≥65 years, laboratory confirmed for RSV, influenza or SARS-CoV-2. Using a binomial regression with logarithmic link, we estimated the relative risk (RR) of pneumonia, ICU admission and in-hospital mortality, in patients with RSV compared to influenza or SARS-CoV-2, adjusting for age, sex, season and comorbidities. We stratified the estimates by vaccination status for influenza or SARS-CoV2.
Results |
Among patients unvaccinated for influenza or SARS-CoV-2, those with RSV had similar or lower risk of pneumonia [vs. influenza: RR= 0.91 (95% Confidence Interval: 0.72–1.16); vs. SARS-CoV-2: 0.81 (0.67–0.98)], ICU admission [vs. influenza: 0.93 (0.41–2.08); vs. SARS-CoV-2: 1.10 (0.61–1.99)] and mortality [vs. influenza: 0.64 (0.32–1.28); vs. SARS-CoV-2: 0.56 (0.30–1.04)]. Among the vaccinated, results were largely similar except for a higher risk of ICU admission with RSV [vs. influenza: 2.13(1.16–3.89); vs. SARS-CoV-2: 1.83 (1.02–3.28)]
Conclusions |
RSV presented similar or lower intrinsic severity than influenza or SARS-CoV2. Among vaccinated patients, RSV was associated to higher ICU-admission, suggesting the potential for preventive RSV vaccination.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Patients hospitalised with RSV ≥65 years had 28% pneumonia, 4% ICU and 6% lethality. |
• | RSV showed similar or lower intrinsic severity compared to influenza or SARS-CoV-2. |
• | The risk of ICU admission was lower for RSV only among unvaccinated patients. |
• | In patients vaccinated for influenza or SARS-CoV-2 ICU admission was higher for RSV. |
• | Differences by virus for pneumonia or death did not differ by vaccination. |
Keywords : Severe acute respiratory infection, Syncytial respiratory virus, Influenza, SARS-CoV2, ICU admission, Pneumonia, Mortality, Vaccination
Plan
Vol 89 - N° 5
Article 106292- novembre 2024 Retour au numéro
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