Several new antivirals are currently under development for Respiratory Syncytial Virus (RSV). Although RSV is responsible for ~177,000 hospitalizations and 14,000 deaths annually, few epidemiologic studies in hospitalized adults have been conducted over multiple seasons.
A retrospective cohort study was conducted of adults admitted to Northwestern Memorial and Prentice WomenÕs Hospitals (Chicago, IL) from 2009-2015 who had a positive PCR collected for clinical indication with RSV. Cases and key epidemiologic data was collected electronically using Northwestern MedicineÕs Enterprise Data Warehouse. Specific data on clinical presentation, management and outcomes were collected by manual chart review by 2 authors. Descriptive statistics were calculated.
A total of 490 patients were admitted during the study period with a positive PCR for RSV (Demographics and subtype details in table 1). Patients frequently presented with cough (87.7%), fever (43.6%), and shortness of breath (35.6%). Most patients had underlying medical conditions prior to admission (pulmonary 42.2%, cardiac 35.1%, renal 23.6%) and 38.7% had a history of smoking. The most common underlying diseases were lung (42.2%), cardiac (35.1%), and kidney disease (23.6%) as well as a history of smoking (38.7%). ICU admission was rare (26.9%) but frequently associated with the need for mechanical ventilation (mean 10.3 d on vent (Range 1 - 78)). Most patients were discharged home. Among the 16 fatal cases, 14 (87.5%) were admitted to the ICU, 8 (50%) of them required mechanical ventilation, and 14 (87.5%) were immunosuppressed or oncology patients. The predominant RSV subtype appears to change at 3 year intervals (see figure 1).
RSV patients were diverse in their demographics, treatment, and outcomes. Large percentages of admitted patients had underlying chronic illnesses such as lung and heart disease. A high fraction of patients received at least one course of antibiotics during their hospital course.
M. Ison, Gilead: Investigator , Research support
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