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Study: Outcomes of RSV Associated with Acute Respiratory Failure
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The results showed that during a 1-month hospital stay, 13% of individuals who experienced RSV-associated acute respiratory failure died.
New study findings published in the Journal of Infection announced that respiratory syncytial virus (RSV) can cause acute respiratory failure (ARF) in immunocompetent older adults who also have multiple comorbidities. The researchers assessed the clinical characteristics and outcomes for immunocompetent individuals hospitalized for RSV infection.1
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The study authors noted that RSV is associated with the Pneumoviridae family and is one of the most common viruses causing hospitalizations in adults in medical wards and in intensive care units.1
According to the CDC, each year in the US, between 60,000 and 160,000 adults 65 years and older are hospitalized due to RSV, resulting in 6,000 to 10,000 deaths. RSV season typically starts in the fall in the US and hits its peak in the winter months.2 However, researchers noted that the 2022-2023 season saw earlier and more intense cases than previous years.1
When infected with RSV, individuals can experience severe respiratory disease and aggravated preexisting conditions, such as chronic obstructive pulmonary disease (COPD), diabetes, and chronic heart failure.3 Despite numerous amounts of research on the impact RSV, the study authors noted that detailed clinical data on the diagnosis of RSV-associated ARF among immunocompetent individuals is limited.1
The researchers included all consecutive immunocompetent individuals who were hospitalized for ARF and tested positive for RSV from October 1, 2016 to March 1, 2023 at a tertiary hospital in France. Individuals diagnosed with ARF met requirements of needing oxygen for at least 48 hours as researchers recorded the procedure of oxygen delivery. Furthermore, individuals diagnosed with RSV were tested using the nasopharyngeal samples with the QIAstat-Dx Respiratory Panel or the BioFire FilmArray Pneumonia plus Panel, according to study authors.1
In total, the retrospective monocentric study included 104 individuals following the exclusion of 112 individuals due to immunosuppression and an additional 102 individuals because they did not meet the 48-hour oxygen requirement.1 Among the 104 individuals, the median age was 77 years and 93% of individuals had a least 1 pre-existing condition. Additionally, the most common comorbidities included hypertension, any form of heart disease, and COPD. Overall, 64% of individuals experienced acute decompensation of a pre-existing chronic comorbidity when diagnosed with RSV.1
The study authors noted that 77% of the patients received antibiotics, although only 16 individuals displayed a confirmed bacterial superinfection after sputum samples were collected. Additionally, 25% of individuals needed ventilation support and 20% were admitted to the intensive care unit. Among these individuals, the median duration of ventilation was 6 days, and the median length of hospital stay was 11 days, according to study authors.1
The results displayed that among a 1-month hospital stay, 13% of individuals died that experienced RSV associated ARF.1
“This study found a high morbidity and mortality in immunocompetent adults with RSV-associated ARF. Particularly, elderly individuals with underlying respiratory or cardiovascular comorbidities emerged as the primary population at an increased risk,” said study authors, in a press release.1
Limitations in the study included possible “incidental RSV” unrelated to their hospital admission, the whole population of immunocompetent individuals with RSV were not all represented, and individuals with different comorbidities were included, which could suggest unlike prognostic outcomes.1
References
1. Clinical characteristics and outcomes of Respiratory Syncytial Virus-associated ARF in immunocompetent patients: a seven-year experience at a tertiary hospital in France. Journal of Infection. News release. May 14, 2024. Accessed May 20, 2024. https://www.journalofinfection.com/article/S0163-4453(24)00114-2/fulltext.
2. CDC. Respiratory Syncytial Virus Infection (RSV). July 17, 2023. Accessed May 20, 2024. https://www.cdc.gov/rsv/research/index.html.
3. Study Highlights Reduced Disease Severity When Vaccinated Against RSV. Pharmacy Times. News release. April 25, 2024. Accessed May 20, 2024. https://www.pharmacytimes.com/view/study-highlights-reduced-disease-severity-when-vaccinated-against-rsv.
