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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Respiratory syncytial virus burden and risk factors for severe disease in patients presenting to the emergency department with flu-like symptoms or acute respiratory failure
Respiratory Medicine, Volume 218, Article 107404, Year 2023
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Description
Background: Predictors of Respiratory Syncytial Virus (RSV) infection and determinants of RSV unfavorable outcomes are still unclear. We assessed RSV burden and investigated the risk factors associated with RSV positive swab and RSV severe disease. Methods: A retrospective, single center, cohort study included all consecutive patients referred to the emergency department of L. Sacco University Hospital (Milan) with flu-like symptoms or acute respiratory failure (aRF) tested per protocol for SARS-CoV-2, RSV, Influenza A (InvA) during the 2022–2023 autumn/winter season. Clinical characteristics and patients’ outcomes were registered. Respiratory failure, need for respiratory support, shock, sepsis or in-hospital death defined severe disease. Main findings: The analysis included 717 patients (65.1% negative swab, 14.1% InvA, 8.5% RSV, 8.6% SARS-CoV-2, 3.6% other viruses). Compared with the study cohort, RSV patients had the highest occurrence of aRF (62.7%) and severe disease (70.5%); mortality was similar to InvA (6.6% vs 5.9%, p = 0.874). Compared with InvA patients, RSV patients were older (p = 0.009), had higher Charlson index (p = 0.001), higher prevalence of chronic heart failure (p = 0.001) and were more frequently on ICS (p = 0.026) and immunosuppressants (p = 0.018). Heart failure [OR (95%CI):3.286 (1.031–10.835); p = 0.041], chronic exposure to ICS [OR (95%CI):2.377 (1.254–4.505); p = 0.008] and immunosuppressants [OR (95%CI):3.661 (1.246–10.754); p = 0.018] predicted RSV infection. Glycaemia ≥120 mg/dL [OR (95%CI):5.839 (1.155–29.519); p = 0.033], leucocytes ≥8000 cells/μL [OR (95%CI):5.929 (1.090–32.268); p = 0.039], and past/active smoking [OR (95%CI):7.347 (1.301–41.500); p = 0.024] predicted severe RSV disease. Conclusions: RSV infection is associated with significant mortality and morbidity. Preventive strategies for RSV infection such as vaccination are highly warranted, especially in older patients with cardiovascular and chronic respiratory conditions. © 2023 Elsevier Ltd
Authors & Co-Authors
Santus, Pierachille
Italy, Milan
Università Degli Studi Di Milano
Radovanovic, Dejan
Italy, Milan
Università Degli Studi Di Milano
Gismondo, Maria Rita
Italy, Milan
Asst Fatebenefratelli Sacco
Gori, Andrea
Italy, Milan
Università Degli Studi Di Milano
Antinori, Spinello
Italy, Milan
Asst Fatebenefratelli Sacco
Rizzardini, Giuliano
Italy, Milan
Asst Fatebenefratelli Sacco
Statistics
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1016/j.rmed.2023.107404
ISSN:
09546111
Research Areas
Health System And Policy
Noncommunicable Diseases
Study Design
Cross Sectional Study
Cohort Study
Study Approach
Quantitative