P Pilie1, W A Werbel2, J Riddell3, X Shu4, D Schaubel4, K S Gregg3. 1. Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA. 2. Department of Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. 3. Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA. 4. Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
Abstract
BACKGROUND: Respiratory syncytial virus (RSV) is a common community-acquired pathogen responsible for a substantial disease burden in adults. We investigated the outcomes after RSV infection in hospitalized adults over a 3-year period. METHODS: This single-center, retrospective study identified 174 patients hospitalized with RSV upper or lower respiratory tract infection (LRTI) between January 1, 2009 and June 30, 2012. Clinical data were extracted from medical records. The primary outcome analyzed was all-cause mortality, defined as death during the index hospital admission. Subjects were divided into 3 groups for comparison: hematopoietic stem cell transplant (HSCT) patients, solid organ transplant (SOT) patients, and non-transplant patients. RESULTS: In our study, 41/174 (23.6%) were HSCT recipients and 28/174 (16.1%) were SOT recipients. Twelve of 174 (6.9%) died. Death occurred in 2/41 (4.9%) HSCT and 3/28 (10.7%) SOT recipients, compared to 7/106 (6.6%) non-transplant patients. When compared to the non-transplant cohort, HSCT and SOT were not found to be significant risk factors for mortality (P = 0.685 and 0.645, respectively). In multivariate logistic regression, age >60 was associated with mortality (P = 0.019), while lymphopenia on admission trended toward an association with death (P = 0.054). HSCT patients were less likely to be admitted to an intensive care unit (odds ratio [OR] 0.26, P = 0.04), but were significantly more likely to receive ribavirin therapy (OR 11.62, P < 0.0001). CONCLUSION: Adults hospitalized with RSV LRTI are at significant risk of mortality, and this risk may be increased in patients age >60 or with lymphopenia on admission. This study did not identify any significant increased mortality or morbidity associated with RSV infection in immune suppressed transplant recipients vs. patients who had not received a transplant.
BACKGROUND:Respiratory syncytial virus (RSV) is a common community-acquired pathogen responsible for a substantial disease burden in adults. We investigated the outcomes after RSV infection in hospitalized adults over a 3-year period. METHODS: This single-center, retrospective study identified 174 patients hospitalized with RSV upper or lower respiratory tract infection (LRTI) between January 1, 2009 and June 30, 2012. Clinical data were extracted from medical records. The primary outcome analyzed was all-cause mortality, defined as death during the index hospital admission. Subjects were divided into 3 groups for comparison: hematopoietic stem cell transplant (HSCT) patients, solid organ transplant (SOT) patients, and non-transplant patients. RESULTS: In our study, 41/174 (23.6%) were HSCT recipients and 28/174 (16.1%) were SOT recipients. Twelve of 174 (6.9%) died. Death occurred in 2/41 (4.9%) HSCT and 3/28 (10.7%) SOT recipients, compared to 7/106 (6.6%) non-transplant patients. When compared to the non-transplant cohort, HSCT and SOT were not found to be significant risk factors for mortality (P = 0.685 and 0.645, respectively). In multivariate logistic regression, age >60 was associated with mortality (P = 0.019), while lymphopenia on admission trended toward an association with death (P = 0.054). HSCT patients were less likely to be admitted to an intensive care unit (odds ratio [OR] 0.26, P = 0.04), but were significantly more likely to receive ribavirin therapy (OR 11.62, P < 0.0001). CONCLUSION: Adults hospitalized with RSV LRTI are at significant risk of mortality, and this risk may be increased in patients age >60 or with lymphopenia on admission. This study did not identify any significant increased mortality or morbidity associated with RSV infection in immune suppressed transplant recipients vs. patients who had not received a transplant.
Authors: Nicole Pribut; Thomas M Kaiser; Robert J Wilson; Edgars Jecs; Zackery W Dentmon; Stephen C Pelly; Savita Sharma; Perry W Bartsch; Pieter B Burger; Soyon S Hwang; Thalia Le; Julien Sourimant; Jeong-Joong Yoon; Richard K Plemper; Dennis C Liotta Journal: ACS Infect Dis Date: 2020-04-20 Impact factor: 5.084
Authors: Edward Walsh; Nelson Lee; Ian Sander; Robert Stolper; Jessica Zakar; Veronique Wyffels; David Myers; Roman Fleischhackl Journal: Health Sci Rep Date: 2022-04-14
Authors: Nelson Lee; Edward E Walsh; Ian Sander; Robert Stolper; Jessica Zakar; Veronique Wyffels; David Myers; Roman Fleischhackl Journal: J Infect Dis Date: 2019-08-09 Impact factor: 5.226
Authors: Alpana Waghmare; Hu Xie; Louise Kimball; Jessica Yi; Sezen Özkök; Wendy Leisenring; Guang-Shing Cheng; Janet A Englund; Timothy R Watkins; Jason W Chien; Michael Boeckh Journal: J Infect Dis Date: 2017-12-05 Impact factor: 5.226