In-hospital and midterm out-hospital complications of adults hospitalised with respiratory syncytial virus infection in France, 2017-2019: an observational study

Alexandre Descamps (1) , Nezha Lenzi (2) , Florence Galtier (3, 4, 2) , Fabrice Lainé (5, 6) , Zineb Lesieur (2) , Philippe Vanhems (7, 2, 8) , Sélilah Amour (7, 8) , Anne-Sophie L’honneur (9) , Nadhira Fidouh (10) , Vincent Foulongne (4, 11) , Gisèle Lagathu (6) , Xavier Duval (12, 2) , Corinne Merle (4) , Bruno Lina (8) , Fabrice Carrat (13) , Odile Launay (1, 2, 9) , Paul Loubet (14, 15, 2)

1 CIC 1417 - CIC Cochin Pasteur
2 F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC)
3 CIC Montpellier
4 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
5 CIC - Centre d'Investigation Clinique [Rennes]
6 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
7 CIRI - Centre International de Recherche en Infectiologie
8 HCL - Hospices Civils de Lyon
9 Hôpital Cochin [AP-HP]
10 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
11 PCCEI - Pathogenesis and Control of Chronic and Emerging Infections
12 CIC 1425 - Centre d'investigation Clinique [CHU Bichat] - Épidémiologie clinique
13 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
14 CHU Nîmes - Centre Hospitalier Universitaire de Nîmes
15 VBIC - Virulence Bactérienne et Infections Chroniques

Objectives - The purpose of this study was to describe the clinical characteristics and in-hospital and post-discharge outcomes of respiratory syncytial virus (RSV) infection among adults hospitalised with influenza-like illness (ILI) and compared against patients admitted for influenza. Methods - Adults hospitalised with ILI were prospectively included from five French university hospitals over two consecutive winter seasons (2017/2018 and 2018/2019). RSV and influenza virus were detected by multiplex reverse transcription PCR on nasopharyngeal swabs. RSV-positive patients were compared to RSV-negative and influenza-positive hospitalised patients. Poisson regression models were used to estimate the adjusted prevalence ratio (aPR) associated with in-hospital and post-discharge outcomes between RSV and influenza infections. The in-hospital outcome was a composite of the occurrence of at least one complication, length of stay ≥7 days, intensive care unit admission, use of mechanical ventilation and in-hospital death. Post-discharge outcome included 30- and 90-day all-cause mortality and 90-day readmission rates. Results - Overall, 1428 hospitalised adults with ILI were included. RSV was detected in 8% (114 of 1428) and influenza virus in 31% (437 of 1428). Patients hospitalised with RSV were older than those with influenza (mean age 73.0 68.8 years, p=0.015) with a higher frequency of chronic respiratory or cardiac disease (52% 39%, p=0.012, and 52% 41%, p=0.039, respectively) and longer hospitalisation duration (median stay 8 6 days, p<0.001). Anti-influenza therapies were less prescribed among RSV patients than influenza patients (20% 66%, p<0.001). In-hospital composite outcome was poorer in RSV patients (aPR 1.5, 95% CI 1.1-2.1) than in those hospitalised with influenza. No difference was observed for the post-discharge composite outcome (aPR 1.1, 95% CI 0.8-1.6). Conclusion - RSV infection results in serious respiratory illness, with worse in-hospital outcomes than influenza and with similar midterm post-discharge outcomes.

Domaines: Sciences du Vivant [q-bio]; Pneumologie et système respiratoire

Alexandre Descamps, Nezha Lenzi, Florence Galtier, Fabrice Lainé, Zineb Lesieur, et al.. In-hospital and midterm out-hospital complications of adults hospitalised with respiratory syncytial virus infection in France, 2017-2019: an observational study. European Respiratory Journal, 2022, 59 (3), pp.2100651. ⟨10.1183/13993003.00651-2021⟩. ⟨hal-03333590⟩