648. Respiratory Syncytial Virus Infection in Adults Hospitalized with Influenza-like illness in France.
Session: Poster Abstract Session: Oh, Those Pesky Viruses!
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • IDWeek2016_Fluvac_Loubet_Launay_FV.pdf (1.9 MB)
  • Background: Few studies have evaluated RSV infection burden in adults. We describe the characteristics of RSV infection compared to influenza infection in adults hospitalized with Influenza-like Illness (ILI).

    Methods: Adult patients hospitalized with ILI were recruited during influenza circulation in an observational prospective study of influenza vaccine effectiveness conducted in five teaching hospitals in France from 2012 to 2015. Nasopharyngeal swabs from enrollees were analyzed for the presence of RSV and other respiratory viruses by multiplex reverse transcription polymerase chain reaction. Standardized information on demographics, clinical presentation and outcomes were collected. We compared characteristics of patients hospitalized with RSV infection with those hospitalized with influenza infection.

    Results: Of 1 452 patients with ILI, 777 (54%) were positive for at least one respiratory virus. Of those, 59 (8%) had an RSV infection and 422 (54%) an influenza infection (6 were infected with both RSV and Influenza and were removed from the analysis). Patients with RSV were mostly older than 65 years (65%) and had at least one chronic underlying disease (85%). Among patients with RSV, 30 (58%) patients had complications; mainly pneumonia (23, 44%) and respiratory failure (15, 29%), 8 (15%) were admitted to ICU and 4 (8%) died during hospitalization. When compared to those with influenza, adults with RSV were older (Median age (IQR) 74 (61-84) vs. 68 (52-81), p=0.05), had more solid cancer (23% vs. 9%, p=0.003) or immunosuppressive treatment (28% vs. 14%, p=0.009), reported more dyspnea (85% vs. 73%, p=0.07) and were more likely to have pneumonia as a complication (44% vs. 28%, p=0.02). Among all patients with at least one virus detected (n=777), RSV infection was the only independent factor associated with the occurrence of pneumonia (OR 2.5 95%CI [1.3-5.0], p=0.008).

    Conclusion: Patients hospitalized with ILI due to RSV infection were older, more likely to be immunocompromised and to develop pneumonia than those with influenza infection. Development of RSV vaccines and appropriate treatments are needed for older and immunocompromised adults.

    Paul Loubet, MD1,2, Nezha Samih-Lenzi, PhD3, Martine Valette, PhD4, Xavier Duval, MD, PhD5, Etienne Canoui, MD2, Florence Galtier, MD6, Déborah Postil, MD7, Stephane Jouneau, MD, PhD8, Philippe Vanhems, MD, PhD9, Fabrice Carrat, MD, PhD10, Bruno Lina, MD, PhD11, Odile Launay, MD, PhD3 and FLUVAC Study Group, (1)Inserm, CIC 1417, Paris, France, (2)Department of Infectious Diseases, Assistance Publique-Hôpitaux de Paris (AP-HP),, Paris, France, (3)Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France, (4)CNR Virus Influenza, Hospices Civils de Lyon, Bron, France, (5)CIC de Bichat, Hôpital Bichat-Claude Bernard, APHP, Paris, France, (6)CIC de Montpellier , Hôpital Saint-Eloi, CHU de Montpellier, Montpellier, France, (7)CIC de Limoges, CHU Dupuytren, Limoges, Limoges, France, (8)Service De Pneumologie, Hôpital Pontchaillou, CHU de Rennes, Rennes, France, (9)International Center for Infectiology Research (CIRI), Laboratory of Emerging Pathogens, UCBL1, Lyon, France, (10)Umrs 1136, Université Pierre et Marie Curie, Paris, France, (11)Cnr Virus Influenza Hcl, University of Lyon, Lyon, France

    Disclosures:

    P. Loubet, None

    N. Samih-Lenzi, None

    M. Valette, None

    X. Duval, None

    E. Canoui, None

    F. Galtier, None

    D. Postil, None

    S. Jouneau, None

    P. Vanhems, None

    F. Carrat, None

    B. Lina, None

    O. Launay, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.