Journal Article

RSV Risk Profile in Hospitalized Adults and Comparison with Influenza and COVID-19 Controls in Valladolid, Spain, 2010–2022

Haeberer, Mariana, Mengel, Martin, He, Yongzheng, Uppal, Sonal, Liang, Caihua, Martin-Toribio, Alejandro, Eiros, José M., Fan, Rong, Toquero-Asensio, Marina, Rojo-Rello, Silvia, Sanz-Muñoz, Ivan, Begier, Elizabeth, Domínguez-Gil, Marta, Castrodeza Sanz, Javier, Fernández-Espinilla, Virginia, Liu, Qing, Hernán-García, Cristina

2024

Overview

Introduction We aimed to describe the risk profile of respiratory syncytial virus (RSV) infections among adults ≥ 60 years in Valladolid from January 2010 to August 2022, and to compare them with influenza and COVID-19 controls. Methods This was a retrospective cohort study of all laboratory-confirmed RSV infections identified in centralized microbiology database during a 12-year period. We analyzed risk factors for RSV hospitalization and severity (length of stay, intensive care unit admission, in-hospital death or readmission < 30 days) and compared severity between RSV patients vs. influenza and COVID-19 controls using multivariable logistic regression models. Results We included 706 RSV patients (635 inpatients and 71 outpatients), and 598 influenza and 60 COVID-19 hospitalized controls with comparable sociodemographic profile. Among RSV patients, 96 (15%) had a subtype identified: 56% A, 42% B, and 2% A + B. Eighty-one percent of RSV patients had cardiovascular conditions, 65% endocrine/metabolic, 46% chronic lung, and 43% immunocompromising conditions. Thirty-six percent were coinfected (vs. 21% influenza and 20% COVID-19; p  =  < .0001 and 0.01). Ninety-two percent had signs of lower respiratory infection (vs. 85% influenza and 72% COVID-19, p  =  < .0001) and 27% cardiovascular signs (vs. 20% influenza and 8% COVID-19, p  = 0.0031 and 0.0009). Laboratory parameters of anemia, inflammation, and hypoxemia were highest in RSV. Among RSV, being a previous smoker (adjusted OR 2.81 [95% CI 1.01, 7.82]), coinfection (4.34 [2.02, 9.34]), and having cardiovascular (3.79 [2.17, 6.62]), neurologic (2.20 [1.09, 4.46]), or chronic lung (1.93 [1.11, 3.38]) diseases were risks for hospitalization. Being resident in care institutions (1.68 [1.09, 2.61]) or having a coinfection (1.91[1.36, 2.69]) were risks for higher severity, while RSV subtype was not associated with severity. Whereas RSV and influenza patients did not show differences in severity, RSV patients had 68% (38–84%) lower odds of experiencing any severe outcome compared to COVID-19. Conclusions RSV especially affects those with comorbidities, coinfections, and living in care institutions. RSV vaccination could have an important public health impact in this population.

• Publisher: Springer Healthcare,Springer,Springer Nature B.V,Adis, Springer Healthcare
• Subject: Adult patients / Adults / Cardiac patients / Comorbidity / Comparative analysis / Control / COVID-19 / Hospital patients / Hospitalization / Hypoxemia / Infectious Diseases / Influenza / Internal Medicine / Lung diseases / Medicine / Medicine & Public Health / Microbiology / Original Research / Pharmaceutical industry / Public health / Respiratory syncytial virus / Risk factors / SARS-CoV-2 / Vaccination