Older patients with RSV have higher complication rates than those with flu
Click Here to Manage Email Alerts
Key takeaways:
- Patients with RSV had more respiratory symptoms, whereas patients with influenza had more general symptoms.
- Patients with RSV had higher rates of hospitalization, ICU admission and pneumonia.
Older patients with respiratory syncytial virus have higher complication rates than those with influenza, although both illnesses had comparable mortality rates, researchers found.
“Back in 2017, during the first semester of my internship in Geriatrics Internal Medicine, I had a severely ill patient, in whom the only diagnosis we had was a respiratory syncytial virus (RSV) infection that led to cardiopulmonary insufficiency,” Caryn Recto, MD, contract hospital practitioner at the Henri Mondor University Hospital, told Healio.
“After this case, and with the knowledge at the time that RSV infections were severe ‘only in children’ and ‘benign and almost asymptomatic’ in adults, I became more and more interested in the subject,” she said.
After meeting Slim Fourati, MD, PhD, a professor in clinical virology and university lecturer at the Henri Mondor Hospital, Recto began working on RSV infections in the elderly, leading to the current study assessing RSV vs. influenza in patients aged 75 years and older.
Recto and colleagues conducted a single-center retrospective study of all patients aged 75 years and older receiving care at a French university hospital during seven epidemic seasons to compare all-cause mortality at day 30. Secondary study outcomes included comparing clinical presentation, and rates of consolidative pneumonia, hospitalization and ICU admission.
In total, 558 patients were included in the study — 125 with RSV and 433 with influenza. The study demonstrated that patients with RSV had more respiratory symptoms such as wheezing (32.8% vs. 15.9%) and dyspnea (64% vs. 44.1%), whereas patients with influenza had more general symptoms, including fever (48.4% vs. 33.6%), asthenia (54.3% vs. 36.8%) and myalgia (19.9% vs. 6.4%).
The study also showed that older patients with RSV had higher complication rates, including for higher rates of consolidative pneumonia (28.8% vs. 17.2%), higher rates of hospitalization (83.2% vs. 70%), higher rates of ICU admission (7.2% vs. 3%) and longer lengths of stay (9 days vs. 5 days). Mortality rates, however, were comparable — 9.6% for patients with RSV and 9.7% for patients with influenza (P = .973).
“Even though there are no pathognomonic signs or signs allowing clinicians to clinically differentiate RSV from flu, I think there are some major clinical take-home messages that could help clinicians suspect the responsible virus,” Recto said.
She explained that RSV clinical presentation differs slightly from that of influenza, with RSV-infected patients having more respiratory symptoms, fewer general symptoms and higher oxygen requirements, radiological pneumonia rates and white blood cell counts, leading to higher antibiotic prescriptions due to suspected bacterial coinfection.
Based on these findings, Recto concluded that “RSV infections are as deadly as flu infections, but with higher comorbidity and, consequently, higher health care expenses.”
Collapse
Read more about
Click Here to Manage Email Alerts