Severity of respiratory syncytial virus compared with SARS-CoV-2 and influenza among hospitalised adults ≥65 years.
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Vega-Piris Lorena, Carretero Silvia Galindo, Mayordomo José Luis, Zarzuelo Mercedes Belén Rumayor, Río Virginia Álvarez, García Virtudes Gallardo, Vázquez Miriam García, Rodríguez María Del Carmen García, Basile Luca, González-Coviella Nieves López, Boada Maria Isabel Barranco, Pérez-Martínez Olaia, Azevedo Ana Lameiras, Rubio Carmen Quiñones, Duran Jaume Giménez, Ibáñez Ana Fernández, Rivera María Victoria García, Marín Violeta Ramos, Castrillejo Daniel, Raymundo Luis Javier Viloria, Larrauri Amparo, Monge Susana, SARI Sentinel Surveillance Group
Аннотация
METHODS: We included hospitalised patients from Severe Acute Respiratory Infection Surveillance in Spain between 2021-2024, aged ≥65 years, laboratory confirmed for RSV, influenza or SARS-CoV-2. Using a binomial regression with logarithmic link, we estimated the relative risk (RR) of pneumonia, ICU admission and in-hospital mortality, in patients with RSV compared to influenza or SARS-CoV-2, adjusting for age, sex, season and comorbidities. We stratified the estimates by vaccination status for influenza or SARS-CoV2.
RESULTS: Among patients unvaccinated for influenza or SARS-CoV-2, those with RSV had similar or lower risk of pneumonia [vs. influenza: RR= 0.91 (95% Confidence Interval: 0.72-1.16); vs. SARS-CoV-2: 0.81 (0.67-0.98)], ICU admission [vs. influenza: 0.93 (0.41-2.08); vs. SARS-CoV-2: 1.10 (0.61-1.99)] and mortality [vs. influenza: 0.64 (0.32-1.28); vs. SARS-CoV-2: 0.56 (0.30-1.04)]. Among the vaccinated, results were largely similar except for a higher risk of ICU admission with RSV [vs. influenza: 2.13(1.16-3.89); vs. SARS-CoV-2: 1.83 (1.02-3.28)] CONCLUSIONS: RSV presented similar or lower intrinsic severity than influenza or SARS-CoV2. Among vaccinated patients, RSV was associated to higher ICU-admission, suggesting the potential for preventive RSV vaccination.