2017-2019年加拿大安大略省成人呼吸道合胞病毒相关住院发生率

Sarah A Buchan,Jenna Alessandrini,Samantha S M Drover,Melissa K Andrew,Susan E Bronskill,Kevin A Brown,Nick Daneman,Shelley L Deeks,Jonathan B Gubbay,Jennie Johnstone,Timothy M Karnauchow,Samantha Lee,Allison J McGeer,J Dayre McNally,Shelly A McNeil,Samira Mubareka,Michelle Murti,Marek Smieja,Sarah E Wilson,Jeffrey C Kwong
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We calculated incidence of hospitalization with 95% confidence intervals (CIs) using Poisson regression stratified by demographic and clinical risk factors, and substratified by age. We reported secondary outcomes including the proportion of individuals with fatal outcomes.\r\n\r\nRESULTS\r\nOver 2 respiratory virus seasons, we identified 3928 RSV-associated hospitalizations. Incidence increased steadily with age from 2.0 (95% CI, 1.8-2.3) per 100 000 for those aged 18-49 years to 43.7 (95% CI, 41.0-46.6) per 100 000 for those aged 70-79 years, with a sharp increase to 134.7 (95% CI, 128.6-141.1) per 100 000 for those aged ≥ 80 years. Incidence was higher for those with comorbidities, including chronic kidney disease (receiving dialysis) (494.7; 95% CI, 410.7-595.8) and transplant recipients (370.9; 95% CI, 318.0-432.6), as well as for those living in lower (22.4; 95% CI, 21.1-23.7) versus higher-income neighborhoods (11.8; 95% CI, 10.8-12.8). 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摘要

背景呼吸道合胞病毒(RSV)在成人中引起大量发病率和死亡率。鉴于最近RSV疫苗获得批准,需要有关最高风险群体的数据来支持疫苗规划决策。方法选取加拿大安大略省(2017-2019)年龄≥18岁的实验室确诊RSV住院患者和RSV相关诊断代码住院患者。我们使用泊松回归计算住院发生率,95%置信区间(ci)按人口学和临床危险因素分层,并按年龄分层。我们报告了次要结局,包括有致命结局的个体比例。结果在2个呼吸道病毒季节,我们发现3928例rsv相关的住院病例。随着年龄的增长,发病率稳步上升,从18-49岁人群的2.0 / 10万(95% CI, 1.8-2.3)上升到70-79岁人群的43.7 / 10万(95% CI, 41.0-46.6),而≥80岁人群的发病率急剧上升至134.7 / 10万(95% CI, 128.6-141.1)。有合并症的患者发病率更高,包括慢性肾脏疾病(接受透析)(494.7;95% CI, 410.7-595.8)和移植受者(370.9;95% CI, 318.0-432.6),以及生活在较低(22.4;95% CI, 21.1-23.7)与高收入社区(11.8;95% ci, 10.8-12.8)。在住院患者中,10.3% (n = 403)在入院30天内死亡,93.1%的死亡发生在年龄≥60岁的患者中。在幸存者中,44.6%的≥60岁的社区居民在出院时功能下降,需要正式的支持。讨论:我们发现RSV在老年人中有很大的负担,特别是在那些已有疾病和社会经济地位较低的老年人中。这些结果将为成人提供公平的疫苗建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidence of Respiratory Syncytial Virus-Associated Hospitalization Among Adults in Ontario, Canada, 2017-2019.
BACKGROUND Respiratory syncytial virus (RSV) causes substantial morbidity and mortality among adults. Given recent RSV vaccine authorizations, data on groups at highest risk are needed to support vaccine program decision making. METHODS We identified adults aged ≥ 18 years hospitalized with laboratory-confirmed RSV and hospitalizations with RSV-related diagnostic codes in Ontario, Canada (2017-2019). We calculated incidence of hospitalization with 95% confidence intervals (CIs) using Poisson regression stratified by demographic and clinical risk factors, and substratified by age. We reported secondary outcomes including the proportion of individuals with fatal outcomes. RESULTS Over 2 respiratory virus seasons, we identified 3928 RSV-associated hospitalizations. Incidence increased steadily with age from 2.0 (95% CI, 1.8-2.3) per 100 000 for those aged 18-49 years to 43.7 (95% CI, 41.0-46.6) per 100 000 for those aged 70-79 years, with a sharp increase to 134.7 (95% CI, 128.6-141.1) per 100 000 for those aged ≥ 80 years. Incidence was higher for those with comorbidities, including chronic kidney disease (receiving dialysis) (494.7; 95% CI, 410.7-595.8) and transplant recipients (370.9; 95% CI, 318.0-432.6), as well as for those living in lower (22.4; 95% CI, 21.1-23.7) versus higher-income neighborhoods (11.8; 95% CI, 10.8-12.8). Among those hospitalized, 10.3% (n = 403) died within 30 days of admission, and 93.1% of deaths occurred in those aged ≥ 60 years. Of survivors, 44.6% of community-dwelling adults aged ≥ 60 years had functional decline requiring formal supports at discharge. DISCUSSION We found a substantial burden of RSV among older adults, particularly among those with preexisting medical conditions and those of lower socioeconomic status. These results will inform equitable vaccine recommendations for adults.
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