Respiratory syncytial virus-associated acute respiratory illness in adult non-immunocompromised patients : Outcomes, determinants of outcomes, and the effect of oral ribavirin treatment
© 2022 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd..
BACKGROUND: Respiratory syncytial virus (RSV) is an increasingly common cause of respiratory illness in adult non-immunocompromised patients. Oral ribavirin was reported to improve outcomes of RSV infection in immunocompromised patients. This study aimed to determine the outcomes of non-immunocompromised patients hospitalized with RSV-associated acute respiratory illnesses (RSV-ARI), the factors independently associated with the outcomes and the effect of oral ribavirin treatment.
METHODS: This retrospective, observational cohort study included 175 adults admitted to the hospital with virologically confirmed RSV-ARI during 2014-2019. Severe ARI was identified using Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) criteria for severe community-acquired pneumonia. The primary outcome was all-cause mortality within 30 days after enrollment. A multivariable Cox model was performed to identify significant predictors of mortality.
RESULTS: Mean age was 76 ± 12.7 years. Seventy-eight (44.6%) patients met the diagnostic criteria for severe ARI. Thirty-six (20.6%) patients required invasive mechanical ventilation, and 11 (6.3%) required vasopressor. Ninety-nine (56.6%) patients received oral ribavirin treatment, and 52 (29.7%) received systemic corticosteroids. Forty-one (23.4%) patients had evidence of bacterial infection. Overall mortality was 7.4%. Mortality among patients with non-severe ARI and severe ARI was 1.04% and 15.4%, respectively. Estimated glomerular filtration rate <50 ml/min/1.73 m2 , severe ARI, systemic corticosteroids, and bacterial infection were independently associated with higher risk of mortality. Treatment with oral ribavirin was the only factor associated with reduced mortality (adjusted HR: 0.19, 95% CI: 0.04-0.9, P = 0.03).
CONCLUSION: RSV-ARI may result in significant mortality and health care utilization. Treatment with oral ribavirin may improve survival in these patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
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| Enthalten in: |
Influenza and other respiratory viruses - 16(2022), 4 vom: 19. Juli, Seite 767-779 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Wongsurakiat, Phunsup [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 10.06.2022 Date Revised 03.09.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/irv.12971 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM336822014 |
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| 245 | 1 | 0 | |a Respiratory syncytial virus-associated acute respiratory illness in adult non-immunocompromised patients |b Outcomes, determinants of outcomes, and the effect of oral ribavirin treatment |
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| 520 | |a © 2022 The Authors. Influenza and Other Respiratory Viruses published by John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND: Respiratory syncytial virus (RSV) is an increasingly common cause of respiratory illness in adult non-immunocompromised patients. Oral ribavirin was reported to improve outcomes of RSV infection in immunocompromised patients. This study aimed to determine the outcomes of non-immunocompromised patients hospitalized with RSV-associated acute respiratory illnesses (RSV-ARI), the factors independently associated with the outcomes and the effect of oral ribavirin treatment | ||
| 520 | |a METHODS: This retrospective, observational cohort study included 175 adults admitted to the hospital with virologically confirmed RSV-ARI during 2014-2019. Severe ARI was identified using Infectious Diseases Society of America/American Thoracic Society (IDSA/ATS) criteria for severe community-acquired pneumonia. The primary outcome was all-cause mortality within 30 days after enrollment. A multivariable Cox model was performed to identify significant predictors of mortality | ||
| 520 | |a RESULTS: Mean age was 76 ± 12.7 years. Seventy-eight (44.6%) patients met the diagnostic criteria for severe ARI. Thirty-six (20.6%) patients required invasive mechanical ventilation, and 11 (6.3%) required vasopressor. Ninety-nine (56.6%) patients received oral ribavirin treatment, and 52 (29.7%) received systemic corticosteroids. Forty-one (23.4%) patients had evidence of bacterial infection. Overall mortality was 7.4%. Mortality among patients with non-severe ARI and severe ARI was 1.04% and 15.4%, respectively. Estimated glomerular filtration rate <50 ml/min/1.73 m2 , severe ARI, systemic corticosteroids, and bacterial infection were independently associated with higher risk of mortality. Treatment with oral ribavirin was the only factor associated with reduced mortality (adjusted HR: 0.19, 95% CI: 0.04-0.9, P = 0.03) | ||
| 520 | |a CONCLUSION: RSV-ARI may result in significant mortality and health care utilization. Treatment with oral ribavirin may improve survival in these patients | ||
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