在≥65 岁的住院成年人中，呼吸道合胞病毒与 SARS-CoV-2 和流感的严重程度进行比较。

IF 14.3 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection Pub Date : 2024-09-26 DOI:10.1016/j.jinf.2024.106292

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引用次数: 0

摘要

导言我们的目的是估算与流感或 COVID-19 相比，≥65 岁的 RSV 住院患者患肺炎、入住重症监护室 (ICU) 或死亡的风险：我们纳入了 2021-2024 年间西班牙严重急性呼吸道感染监测中年龄≥65 岁、实验室确诊为 RSV、流感或 SARS-CoV-2 的住院患者。通过二项回归与对数链接，我们估算了与流感或 SARS-CoV-2 相比，RSV 患者患肺炎、入住重症监护室和院内死亡的相对风险 (RR)，并对年龄、性别、季节和合并症进行了调整。我们根据流感或 SARS-CoV2 疫苗接种情况对估计值进行了分层：结果：在未接种流感疫苗或 SARS-CoV-2 疫苗的患者中，RSV 感染者患肺炎的风险相似或更低[与流感相比，RR=0.91（95%）]：RR=0.91（95% 置信区间：0.72-1.16）；vs. SARS-CoV-2：0.81（0.67-0.98）]、入住重症监护室的风险[vs. 流感：0.93（0.41-2.08）；vs. SARS-CoV-2：1.10（0.61-1.99）]和死亡率[vs. 流感：0.64（0.32-1.28）；vs. SARS-CoV-2：0.56（0.30-1.04）]。在接种疫苗的人群中，除了 RSV 的 ICU 入院风险较高之外，其他结果基本相似[与流感相比：2.13（1.16-3.89）；与 SARS-CoV-2 相比：1.83（1.02-3.28）] 结论：RSV 与流感的内在风险相似或更低：RSV 的内在严重性与流感或 SARS-CoV2 相似或更低。在接种过疫苗的患者中，RSV 与较高的 ICU 入院率相关，这表明预防性 RSV 疫苗接种具有潜力。

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Severity of respiratory syncytial virus compared with SARS-CoV-2 and influenza among hospitalised adults ≥65 years

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.

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来源期刊

Journal of Infection 医学-传染病学

CiteScore

45.90

自引率

3.20%

发文量

475

审稿时长

16 days

期刊介绍： The Journal of Infection publishes original papers on all aspects of infection - clinical, microbiological and epidemiological. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in the ever-changing field of infection. Each issue brings you Editorials that describe current or controversial topics of interest, high quality Reviews to keep you in touch with the latest developments in specific fields of interest, an Epidemiology section reporting studies in the hospital and the general community, and a lively correspondence section.