Severity of Respiratory Syncytial Virus vs COVID-19 and Influenza Among Hospitalized US Adults

被引：18

作者：

Surie, Diya ^{[1
,2
]}

Yuengling, Katharine A. ^{[1
,2
]}

DeCuir, Jennifer ^{[1
,2
]}

Zhu, Yuwei ^{[3
]}

Lauring, Adam S. ^{[4
,5
]}

Gaglani, Manjusha ^{[6
,7
,8
]}

Ghamande, Shekhar ^{[6
,7
,8
]}

Peltan, Ithan D. ^{[9
,10
]}

Brown, Samuel M. ^{[9
,10
]}

Ginde, Adit A. ^{[11
]}

Martinez, Amanda ^{[11
]}

Mohr, Nicholas M. ^{[12
]}

Gibbs, Kevin W. ^{[13
]}

Hager, David N. ^{[14
]}

Ali, Harith ^{[14
]}

Prekker, Matthew E. ^{[15
]}

Gong, Michelle N. ^{[16
]}

Mohamed, Amira ^{[16
]}

Johnson, Nicholas J. ^{[17
]}

Srinivasan, Vasisht ^{[18
]}

Steingrub, Jay S. ^{[19
]}

Leis, Aleda M. ^{[20
]}

Khan, Akram ^{[21
]}

Hough, Catherine L. ^{[21
]}

Bender, William S. ^{[22
]}

Duggal, Abhijit ^{[23
]}

Bendall, Emily E. ^{[5
]}

Wilson, Jennifer G. ^{[24
]}

Qadir, Nida ^{[25
]}

Chang, Steven Y. ^{[25
]}

Mallow, Christopher ^{[26
]}

Kwon, Jennie H. ^{[27
]}

Exline, Matthew C. ^{[28
]}

Shapiro, Nathan I. ^{[29
]}

Columbus, Cristie ^{[30
,31
]}

Vaughn, Ivana A. ^{[32
]}

Ramesh, Mayur ^{[33
]}

Mosier, Jarrod M. ^{[34
]}

Safdar, Basmah ^{[35
]}

Casey, Jonathan D. ^{[36
]}

Talbot, H. Keipp ^{[36
,37
]}

Rice, Todd W. ^{[36
]}

Halasa, Natasha ^{[38
]}

Chappell, James D. ^{[38
]}

Grijalva, Carlos G. ^{[37
]}

Baughman, Adrienne ^{[39
]}

Womack, Kelsey N. ^{[40
]}

Swan, Sydney A. ^{[3
]}

Johnson, Cassandra A. ^{[3
]}

Lwin, Cara T. ^{[3
]}

机构：

[1] CDCP, Natl Ctr Immunizat & Resp Dis, Coronavirus & Other Resp Viruses Div, 1600 Clifton Rd,MS H18-6, Atlanta, GA 30329 USA

[2] CDCP, Natl Ctr Immunizat & Resp Dis, Coronavirus & Other Resp Viruses Div, Atlanta, GA USA

[3] Vanderbilt Univ, Med Ctr, Dept Biostat, Nashville, TN USA

[4] Univ Michigan, Dept Internal Med, Ann Arbor, MI USA

[5] Univ Michigan, Dept Microbiol & Immunol, Ann Arbor, MI USA

[6] Baylor Scott & White Hlth, Temple, TX USA

[7] Texas A&M Univ, Coll Med, Temple, TX USA

[8] Baylor Coll Med, Temple, TX USA

[9] Intermt Med Ctr, Dept Med, Murray, UT USA

[10] Univ Utah, Salt Lake City, UT USA

[11] Univ Colorado, Sch Med, Dept Emergency Med, Aurora, CO USA

[12] Univ Iowa, Iowa City, IA USA

[13] Wake Forest Sch Med, Dept Med, Winston Salem, NC USA

[14] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD USA

[15] Hennepin Cty Med Ctr, Dept Emergency Med, Minneapolis, MN USA

[16] Albert Einstein Coll Med, Montefiore Med Ctr, Dept Med, Bronx, NY USA

[17] Univ Washington, Dept Emergency Med, Div Pulm Crit Care & Sleep Med, Seattle, WA USA

[18] Univ Washington, Dept Emergency Med, Seattle, WA USA

[19] Baystate Med Ctr, Dept Med, Springfield, MA USA

[20] Univ Michigan, Sch Publ Hlth, Ann Arbor, MI USA

[21] Oregon Hlth & Sci Univ, Dept Med, Portland, OR USA

[22] Emory Univ, Dept Med, Atlanta, GA USA

[23] Cleveland Clin, Dept Med, Cleveland, OH USA

[24] Stanford Univ, Sch Med, Dept Emergency Med, Stanford, CA USA

[25] Univ Calif Los Angeles, Dept Med, Los Angeles, CA USA

[26] Univ Miami, Dept Med, Miami, FL USA

[27] Washington Univ, Dept Med, St Louis, MO USA

[28] Ohio State Univ, Dept Med, Columbus, OH USA

[29] Beth Israel Deaconess Med Ctr, Dept Emergency Med, Boston, MA USA

[30] Baylor Scott & White Hlth, Dallas, TX USA

[31] Texas A&M Univ, Coll Med, Dallas, TX USA

[32] Henry Ford Hlth, Dept Publ Hlth Sci, Detroit, MI USA

[33] Henry Ford Hlth, Div Infect Dis, Detroit, MI USA

[34] Univ Arizona, Dept Emergency Med, Tucson, AZ USA

[35] Yale Univ, Sch Med, New Haven, CT USA

[36] Vanderbilt Univ, Med Ctr, Dept Med, Nashville, TN USA

[37] Vanderbilt Univ, Med Ctr, Dept Hlth Policy, Nashville, TN USA

[38] Vanderbilt Univ, Med Ctr, Dept Pediat, Nashville, TN USA

[39] Vanderbilt Univ, Med Ctr, Dept Emergency Med, Nashville, TN USA

[40] Vanderbilt Univ, Med Ctr, Vanderbilt Inst Clin & Translat Res, Nashville, TN USA

[41] CDCP, Influenza Div, Natl Ctr Immunizat & Resp Dis, Atlanta, GA USA

来源：

JAMA NETWORK OPEN | 2024年 / 7卷 / 04期

关键词：

UNITED-STATES; IVY NETWORK; RECOMMENDATIONS; VACCINE;

D O I：

10.1001/jamanetworkopen.2024.4954

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Importance On June 21, 2023, the Centers for Disease Control and Prevention recommended the first respiratory syncytial virus (RSV) vaccines for adults aged 60 years and older using shared clinical decision-making. Understanding the severity of RSV disease in adults can help guide this clinical decision-making. Objective To describe disease severity among adults hospitalized with RSV and compare it with the severity of COVID-19 and influenza disease by vaccination status. Design, Setting, and Participants In this cohort study, adults aged 18 years and older admitted to the hospital with acute respiratory illness and laboratory-confirmed RSV, SARS-CoV-2, or influenza infection were prospectively enrolled from 25 hospitals in 20 US states from February 1, 2022, to May 31, 2023. Clinical data during each patient's hospitalization were collected using standardized forms. Data were analyzed from August to October 2023. Exposures RSV, SARS-CoV-2, or influenza infection. Main Outcomes and Measures Using multivariable logistic regression, severity of RSV disease was compared with COVID-19 and influenza severity, by COVID-19 and influenza vaccination status, for a range of clinical outcomes, including the composite of invasive mechanical ventilation (IMV) and in-hospital death. Results Of 7998 adults (median [IQR] age, 67 [54-78] years; 4047 [50.6%] female) included, 484 (6.1%) were hospitalized with RSV, 6422 (80.3%) were hospitalized with COVID-19, and 1092 (13.7%) were hospitalized with influenza. Among patients with RSV, 58 (12.0%) experienced IMV or death, compared with 201 of 1422 unvaccinated patients with COVID-19 (14.1%) and 458 of 5000 vaccinated patients with COVID-19 (9.2%), as well as 72 of 699 unvaccinated patients with influenza (10.3%) and 20 of 393 vaccinated patients with influenza (5.1%). In adjusted analyses, the odds of IMV or in-hospital death were not significantly different among patients hospitalized with RSV and unvaccinated patients hospitalized with COVID-19 (adjusted odds ratio [aOR], 0.82; 95% CI, 0.59-1.13; P = .22) or influenza (aOR, 1.20; 95% CI, 0.82-1.76; P = .35); however, the odds of IMV or death were significantly higher among patients hospitalized with RSV compared with vaccinated patients hospitalized with COVID-19 (aOR, 1.38; 95% CI, 1.02-1.86; P = .03) or influenza disease (aOR, 2.81; 95% CI, 1.62-4.86; P < .001). Conclusions and Relevance Among adults hospitalized in this US cohort during the 16 months before the first RSV vaccine recommendations, RSV disease was less common but similar in severity compared with COVID-19 or influenza disease among unvaccinated patients and more severe than COVID-19 or influenza disease among vaccinated patients for the most serious outcomes of IMV or death.

引用

页数：16

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