Koos Korsten1, Niels Adriaenssens2,3, Samuel Coenen2,3,4, Christopher Butler5, Behnaz Ravanfar5, Heather Rutter5, Julie Allen5, Ann Falsey6, Jean-Yves Pirçon7, Olivier Gruselle7, Vincent Pavot8, Charlotte Vernhes9, Sunita Balla-Jhagjhoorsingh10, Deniz Öner11, Gabriela Ispas11, Jeroen Aerssens11, Vivek Shinde12, Theo Verheij13, Louis Bont1, Joanne Wildenbeest14. 1. Dept of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. 2. Vaccine and Infectious Disease Institute (VAXINFECTIO), University of Antwerp, Faculty of Medicine and Health Sciences, Antwerp, Belgium. 3. Dept of Primary and Interdisciplinary Care (ELIZA)-Centre for General Practice, University of Antwerp, Faculty of Medicine and Health Sciences, Antwerp, Belgium. 4. Dept of Epidemiology and Social Medicine (ESOC), University of Antwerp, Faculty of Medicine and Health Sciences, Antwerp, Belgium. 5. Nuffield Dept of Primary Care Health Sciences, University of Oxford, Oxford, UK. 6. Dept of Medicine-Infectious Diseases, University of Rochester Medical Center, Rochester, NY, USA. 7. GlaxoSmithKline, Wavre, Belgium. 8. Sanofi Pasteur R&D, Sanofi Pasteur Campus Mérieux, Marcy l'Etoile, France. 9. Sanofi Pasteur R&D, Cambridge, MA, USA. 10. Janssen Vaccines & Prevention BV, Leiden, The Netherlands. 11. Infectious Diseases Translational Biomarkers, Janssen Pharmaceutica NV, Beerse, Belgium. 12. Novavax, Inc., Gaithersburg, MD, USA. 13. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. 14. Dept of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands j.g.wildenbeest@umcutrecht.nl.
Abstract
BACKGROUND: Respiratory syncytial virus (RSV) infection in older adults is recognised as an important health issue. We aimed to assess the community burden of RSV in Europe in older adults aged ≥60 years. METHODS: This international, prospective, observational cohort study is part of work by the REspiratory Syncytial virus Consortium in EUrope (RESCEU). Participants were recruited through general practitioners' (GPs) offices before two independent RSV seasons. Participants reported weekly about symptoms of acute respiratory tract infection (ARTI) during one RSV season. ARTI patients were tested for RSV during home visits and completed a daily symptom diary. RSV illness included PCR-confirmed ARTI and those showing seroconversion over the season. RSV ARTI was based on PCR alone (ClinicalTrials.gov, NCT03621930). RESULTS: We recruited 1040 participants (527 in season 2017-2018 and 513 in season 2018-2019) with a median age of 75 years (range 60-100 years). Of these, 1023 (99%) lived independently at home at baseline. RSV illness incidence was 22 out of 527 (4.2%) and 37 out of 513 (7.2%) in the respective seasons. RSV illness did not affect frailty or cardiopulmonary status during the course of the study. No patients were hospitalised or died from RSV illness. In the 36 patients with PCR confirmed RSV ARTI, symptom duration averaged 19 days, while a doctor's visit took place in 11 out of 36 cases (31%). RSV ARTI could not be differentiated clinically from all other ARTIs based on symptoms. CONCLUSION: This European study showed that RSV is prevalent in community-dwelling older adults and rarely causes severe disease. This suggests that watchful waiting, using a continuity of care approach to identify those who do need more intensive care, is often justified when RSV is suspected in family practice.
BACKGROUND:Respiratory syncytial virus (RSV) infection in older adults is recognised as an important health issue. We aimed to assess the community burden of RSV in Europe in older adults aged ≥60 years. METHODS: This international, prospective, observational cohort study is part of work by the REspiratory Syncytial virus Consortium in EUrope (RESCEU). Participants were recruited through general practitioners' (GPs) offices before two independent RSV seasons. Participants reported weekly about symptoms of acute respiratory tract infection (ARTI) during one RSV season. ARTI patients were tested for RSV during home visits and completed a daily symptom diary. RSV illness included PCR-confirmed ARTI and those showing seroconversion over the season. RSV ARTI was based on PCR alone (ClinicalTrials.gov, NCT03621930). RESULTS: We recruited 1040 participants (527 in season 2017-2018 and 513 in season 2018-2019) with a median age of 75 years (range 60-100 years). Of these, 1023 (99%) lived independently at home at baseline. RSV illness incidence was 22 out of 527 (4.2%) and 37 out of 513 (7.2%) in the respective seasons. RSV illness did not affect frailty or cardiopulmonary status during the course of the study. No patients were hospitalised or died from RSV illness. In the 36 patients with PCR confirmed RSV ARTI, symptom duration averaged 19 days, while a doctor's visit took place in 11 out of 36 cases (31%). RSV ARTI could not be differentiated clinically from all other ARTIs based on symptoms. CONCLUSION: This European study showed that RSV is prevalent in community-dwelling older adults and rarely causes severe disease. This suggests that watchful waiting, using a continuity of care approach to identify those who do need more intensive care, is often justified when RSV is suspected in family practice.
Authors: Koos Korsten; Niels Adriaenssens; Samuel Coenen; Chris C Butler; Theo J M Verheij; Louis J Bont; Joanne G Wildenbeest Journal: J Infect Dis Date: 2022-08-12 Impact factor: 7.759
Authors: Roy P Zuurbier; Koos Korsten; Theo J M Verheij; Chris Butler; Niels Adriaenssens; Samuel Coenen; Olivier Gruselle; Valerie Vantomme; Marlies A van Houten; Louis J Bont; Joanne G Wildenbeest Journal: J Infect Dis Date: 2022-08-12 Impact factor: 7.759
Authors: John M McLaughlin; Farid Khan; Elizabeth Begier; David L Swerdlow; Luis Jodar; Ann R Falsey Journal: Open Forum Infect Dis Date: 2022-06-17 Impact factor: 4.423
Authors: Koos Korsten; Niels Adriaenssens; Samuel Coenen; Chris C Butler; Jean Yves Pirçon; Theo J M Verheij; Louis J Bont; Joanne G Wildenbeest Journal: J Infect Dis Date: 2022-08-12 Impact factor: 7.759