Epidemiology and outcomes of hospitalized adults with respiratory syncytial virus: A 6-year retrospective study

Henry Schmidt, Arighno Das, Hannah Nam, Amy Yang, Michael G Ison*

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: Respiratory syncytial virus (RSV) is an important cause of morbidity and mortality in adults. Existing studies are limited by the number of seasons studied and most have focused on the immunocompromised. Methods: A retrospective cohort study was conducted on all adults (≥18 years) with a positive RSV molecular test admitted from 2009 to 2015 to one hospital in Chicago, IL. Epidemiologic and outcomes data were collected after IRB approval. Results: Of the 489 eligible patients, 227 had RSV A and 262 had RSV B. Patients had a median age of 61 years and comorbidity (eg, chronic lung disease [40.6%], obesity [37.8%], and cardiac disease [34.3%]). On presentation, most had cough (86.5%), fever (42.4%), and shortness of breath (38.2%). Severe disease was present in 27.6% of patients. Antibiotic was used in 76.3% inpatients and 45.8% at discharged despite few patients (4.7%) having documented bacterial infections. Supplemental oxygen and mechanical ventilation were utilized in 44.6% and 12.3%, respectively, while ICU level care was required in 26.9%. Most patients were discharged home (82.7%). Most deaths (68.4%, 13/19) were attributed to pneumonia or hypoxemia likely from RSV. Most fatal cases were seen in those with recent cancer treatment and older adults. Conclusions: Respiratory syncytial virus in hospitalized adults is associated with significant morbidity and mortality with 26.9% requiring ICU level care. Antibiotics are commonly prescribed to patients with documented RSV, and antibiotics are frequently continued after diagnosis. Novel antiviral therapies are needed for RSV to improve outcomes and potentially improve antibiotic stewardship in patients without a bacterial infection.

Original languageEnglish (US)
Pages (from-to)331-338
Number of pages8
JournalInfluenza and other respiratory viruses
Volume13
Issue number4
DOIs
StatePublished - Jul 1 2019

Fingerprint

Respiratory Syncytial Viruses
Epidemiology
Retrospective Studies
Anti-Bacterial Agents
Bacterial Infections
Morbidity
Mortality
Research Ethics Committees
Artificial Respiration
Cough
Dyspnea
Lung Diseases
Antiviral Agents
Comorbidity
Inpatients
Heart Diseases
Pneumonia
Chronic Disease
Cohort Studies
Fever

Keywords

  • RSV
  • hospitalized
  • mortality
  • pneumonia
  • ribavirin

ASJC Scopus subject areas

  • Epidemiology
  • Pulmonary and Respiratory Medicine
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

@article{ca99de441ed64894bf1d2b13f784df29,
title = "Epidemiology and outcomes of hospitalized adults with respiratory syncytial virus: A 6-year retrospective study",
abstract = "Objectives: Respiratory syncytial virus (RSV) is an important cause of morbidity and mortality in adults. Existing studies are limited by the number of seasons studied and most have focused on the immunocompromised. Methods: A retrospective cohort study was conducted on all adults (≥18 years) with a positive RSV molecular test admitted from 2009 to 2015 to one hospital in Chicago, IL. Epidemiologic and outcomes data were collected after IRB approval. Results: Of the 489 eligible patients, 227 had RSV A and 262 had RSV B. Patients had a median age of 61 years and comorbidity (eg, chronic lung disease [40.6{\%}], obesity [37.8{\%}], and cardiac disease [34.3{\%}]). On presentation, most had cough (86.5{\%}), fever (42.4{\%}), and shortness of breath (38.2{\%}). Severe disease was present in 27.6{\%} of patients. Antibiotic was used in 76.3{\%} inpatients and 45.8{\%} at discharged despite few patients (4.7{\%}) having documented bacterial infections. Supplemental oxygen and mechanical ventilation were utilized in 44.6{\%} and 12.3{\%}, respectively, while ICU level care was required in 26.9{\%}. Most patients were discharged home (82.7{\%}). Most deaths (68.4{\%}, 13/19) were attributed to pneumonia or hypoxemia likely from RSV. Most fatal cases were seen in those with recent cancer treatment and older adults. Conclusions: Respiratory syncytial virus in hospitalized adults is associated with significant morbidity and mortality with 26.9{\%} requiring ICU level care. Antibiotics are commonly prescribed to patients with documented RSV, and antibiotics are frequently continued after diagnosis. Novel antiviral therapies are needed for RSV to improve outcomes and potentially improve antibiotic stewardship in patients without a bacterial infection.",
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Epidemiology and outcomes of hospitalized adults with respiratory syncytial virus : A 6-year retrospective study. / Schmidt, Henry; Das, Arighno; Nam, Hannah; Yang, Amy; Ison, Michael G.

In: Influenza and other respiratory viruses, Vol. 13, No. 4, 01.07.2019, p. 331-338.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Epidemiology and outcomes of hospitalized adults with respiratory syncytial virus

T2 - A 6-year retrospective study

AU - Schmidt, Henry

AU - Das, Arighno

AU - Nam, Hannah

AU - Yang, Amy

AU - Ison, Michael G

PY - 2019/7/1

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N2 - Objectives: Respiratory syncytial virus (RSV) is an important cause of morbidity and mortality in adults. Existing studies are limited by the number of seasons studied and most have focused on the immunocompromised. Methods: A retrospective cohort study was conducted on all adults (≥18 years) with a positive RSV molecular test admitted from 2009 to 2015 to one hospital in Chicago, IL. Epidemiologic and outcomes data were collected after IRB approval. Results: Of the 489 eligible patients, 227 had RSV A and 262 had RSV B. Patients had a median age of 61 years and comorbidity (eg, chronic lung disease [40.6%], obesity [37.8%], and cardiac disease [34.3%]). On presentation, most had cough (86.5%), fever (42.4%), and shortness of breath (38.2%). Severe disease was present in 27.6% of patients. Antibiotic was used in 76.3% inpatients and 45.8% at discharged despite few patients (4.7%) having documented bacterial infections. Supplemental oxygen and mechanical ventilation were utilized in 44.6% and 12.3%, respectively, while ICU level care was required in 26.9%. Most patients were discharged home (82.7%). Most deaths (68.4%, 13/19) were attributed to pneumonia or hypoxemia likely from RSV. Most fatal cases were seen in those with recent cancer treatment and older adults. Conclusions: Respiratory syncytial virus in hospitalized adults is associated with significant morbidity and mortality with 26.9% requiring ICU level care. Antibiotics are commonly prescribed to patients with documented RSV, and antibiotics are frequently continued after diagnosis. Novel antiviral therapies are needed for RSV to improve outcomes and potentially improve antibiotic stewardship in patients without a bacterial infection.

AB - Objectives: Respiratory syncytial virus (RSV) is an important cause of morbidity and mortality in adults. Existing studies are limited by the number of seasons studied and most have focused on the immunocompromised. Methods: A retrospective cohort study was conducted on all adults (≥18 years) with a positive RSV molecular test admitted from 2009 to 2015 to one hospital in Chicago, IL. Epidemiologic and outcomes data were collected after IRB approval. Results: Of the 489 eligible patients, 227 had RSV A and 262 had RSV B. Patients had a median age of 61 years and comorbidity (eg, chronic lung disease [40.6%], obesity [37.8%], and cardiac disease [34.3%]). On presentation, most had cough (86.5%), fever (42.4%), and shortness of breath (38.2%). Severe disease was present in 27.6% of patients. Antibiotic was used in 76.3% inpatients and 45.8% at discharged despite few patients (4.7%) having documented bacterial infections. Supplemental oxygen and mechanical ventilation were utilized in 44.6% and 12.3%, respectively, while ICU level care was required in 26.9%. Most patients were discharged home (82.7%). Most deaths (68.4%, 13/19) were attributed to pneumonia or hypoxemia likely from RSV. Most fatal cases were seen in those with recent cancer treatment and older adults. Conclusions: Respiratory syncytial virus in hospitalized adults is associated with significant morbidity and mortality with 26.9% requiring ICU level care. Antibiotics are commonly prescribed to patients with documented RSV, and antibiotics are frequently continued after diagnosis. Novel antiviral therapies are needed for RSV to improve outcomes and potentially improve antibiotic stewardship in patients without a bacterial infection.

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