scholarly journals Clinical and epidemiological impact of respiratory syncytial virus and identification of risk factors for severe disease in children hospitalized due to acute respiratory tract infection

2019 ◽  
Vol 117 (4) ◽  
Author(s):  
Ann R Falsey ◽  
Edward E Walsh ◽  
Stacey House ◽  
Yannick Vandenijck ◽  
Xiaohui Ren ◽  
...  

Abstract Background Respiratory syncytial virus (RSV), human metapneumovirus (hMPV) and influenza are respiratory pathogens leading to hospitalization in adults. Understanding disease burden is limited to data from single-center or one-season studies in elderly patients. The HARTI study allows comparison of risk factors for progression to severe disease and medical resources utilization (MRU) during and post-hospitalization in adults diagnosed with influenza, RSV, or hMPV. Methods This was a prospective global study in adults hospitalized with acute respiratory tract infection (40 centers, 12 countries). Participants with influenza, RSV, or hMPV were enrolled in a substudy and followed up to three months post-discharge. Results Overall, 366 influenza, 238 RSV, and 100 hMPV-infected participants enrolled in the substudy. RSV participants were older, had greater frequency of risk factors, and longer duration of symptoms prior to hospitalization than influenza participants. RSV and hMPV groups received more bronchodilators, corticosteroids, and oxygen supplementation. No significant differences in intensive care unit admissions or complications were observed. Readmission occurred in 20-33% of patients within three months post-discharge, with highest rates for RSV and hMPV. In-hospital death occurred in 2.5% RSV, 1.6% influenza, and 2% hMPV participants. In multivariate analyses, length of stay was independently associated with country, renal disease, and increased age; probability of receiving supplemental oxygen was associated with pathogen (hMPV>RSV>influenza), abnormal chest x-ray, and increased age. Conclusions Although influenza is more frequent, the HARTI study demonstrates greater frequency of underlying risk factors and MRU for RSV and hMPV versus influenza in hospitalized adults, indicating need for effective interventions.


PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3970 ◽  
Author(s):  
Ilada Thongpan ◽  
John Mauleekoonphairoj ◽  
Preeyaporn Vichiwattana ◽  
Sumeth Korkong ◽  
Rujipat Wasitthankasem ◽  
...  

Respiratory syncytial virus (RSV) causes acute lower respiratory tract infection in infants and young children worldwide. To investigate the RSV burden in Thailand over four consecutive years (January 2012 to December 2015), we screened 3,306 samples obtained from children ≤5 years old with acute respiratory tract infection using semi-nested reverse-transcription polymerase chain reaction (RT-PCR). In all, 8.4% (277/3,306) of the specimens tested positive for RSV, most of which appeared in the rainy months of July to November. We then genotyped RSV by sequencing the G glycoprotein gene and performed phylogenetic analysis to determine the RSV antigenic subgroup. The majority (57.4%, 159/277) of the RSV belonged to subgroup A (RSV-A), of which NA1 genotype was the most common in 2012 while ON1 genotype became prevalent the following year. Among samples tested positive for RSV-B subgroup B (RSV-B) (42.6%, 118/277), most were genotype BA9 (92.6%, 87/94) with some BA10 and BA-C. Predicted amino acid sequence from the partial G region showed highly conserved N-linked glycosylation site at residue N237 among all RSV-A ON1 strains (68/68), and at residues N296 (86/87) and N310 (87/87) among RSV-B BA9 strains. Positive selection of key residues combined with notable sequence variations on the G gene contributed to the continued circulation of this rapidly evolving virus.


2018 ◽  
Vol 90 (5) ◽  
pp. 861-866 ◽  
Author(s):  
Miriam Gómez‐Novo ◽  
José A. Boga ◽  
Marta E. Álvarez‐Argüelles ◽  
Susana Rojo‐Alba ◽  
Ana Fernández ◽  
...  

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