RSV linked to hospital death rates typically seen with flu

Patients with respiratory syncytial virus infection (RSV) were also more likely to have underlying chronic respiratory disease and other comorbidities, according to a recent study of people hospitalized in ICUs.

respiratory sincytial virus According to a recent study, (RSV) infection is associated with high in-hospital mortality at levels comparable to influenza infection when adults are admitted to the ICU.

“Influenza is another respiratory virus that is routinely tested in ICU patients with respiratory symptoms because of its known morbidity and mortality, but no study has specifically compared RSV and influenza infections in adult ICU patients,” the authors wrote about their report. motivation for the study, which was published in chest diary

The retrospective study, conducted at 17 sites in France and Belgium, aimed to determine the characteristics and outcomes of adult ICU patients with RSV infection.

Characteristics and outcomes of adult patients with RSV infection were compared with those with influenza infection between November 2011 and April 2018.

Patients with RSV were matched by institution and day of diagnosis with patients with influenza infections. The cohort included 618 patients, 309 with RSV infection and 309 with influenza infection.

When comparing death rates, researchers adjusted for prognostic factors such as gender, age, major underlying conditions, and concomitant bloodstream infection.

Patients with an RSV infection were found to be significantly more likely to have an underlying chronic respiratory disease (60.2% versus 40.1%).

In addition, patients with RSV were significantly more likely to be immunocompromised (35% vs 26.2%).

Only 6.3% of patients were considered young and previously healthy. The proportion of patients with RSV who were young and previously healthy was 2.9%, significantly lower than in patients with influenza (9.7%), indicating that severe RSV infection mainly occurs in patients with comorbidities.

Characteristics at diagnosis varied between groups in patients with critical illness. RSV infection was associated with clinical signs of airway obstruction, with 49.5% of patients showing signs of airway obstruction. 50% of patients with RSV infection were diagnosed chronic obstructive pulmonary diseaseasthmaor both.

The length of stay in ICU and hospital was comparable between patients with RSV and patients with flu.

Mortality was not significantly different between hospitalized patients with RSV infection and influenza infection; the RSV group was 23.9% compared to 25.6% in the flu group.

Based on these findings, the authors suggested the need to identify interventions to prevent and treat severe RSV infection.

The study had several limitations. A causal relationship between the viral infections and patient outcomes could not be demonstrated.

However, 95% of patients showed respiratory symptoms and relatively few showed another detected cause for the respiratory condition, supporting a causal relationship between the viral infections detected and the relatively poor outcomes, according to the authors.

Although patient management was not homogeneous across centers due to local protocols, the authors argue that matching patients by data and hospital reduced the risk of bias in cross-group comparisons.

Reference

Julien C, Benjamin Z, Eve G, et al. Characteristics and outcomes of patients in ICU with respiratory syncytial virus compared with those with influenza infection. FOREST magazine. 2022;161(6):1475-1484. doi:10.1016/j.chest.2021.12.670

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