Clinical characteristics and outcomes in adult patients hospitalized with influenza, respiratory syncytial virus and human metapneumovirus infections. Issue 6 (3rd June 2021)

• Record Type: Journal Article
• Authors: Chen, Liang; Han, Xiudi; Bai, Lu; Zhang, Jian
• Is Part Of: Expert review of anti-infective therapy. Volume 19:Issue 6(2021)
• Page Start: 787
• Page End: 796
• Publication Date: 2021-06-03
• Subjects: Influenza -- respiratory syncytial virus -- human metapneumovirus -- adult -- clinical characteristics -- disease severity; Anti-infective agents -- Research -- Periodicals; 616.90461
• DOI: 10.1080/14787210.2021.1846520
• Languages: English
• ISSNs: 1478-7210

Abstract

ABSTRACT: Objectives : To compare the clinical characteristics and outcomes of patients hospitalized with respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and influenza infections. Methods : This study prospectively enrolled 594 patients hospitalized with influenza-like illness (ILI) and laboratory-confirmed RSV, hMPV, or influenza infections over three consecutive influenza seasons at a tertiary hospital in China. Results : While certain clinical features were of value as predictors of infection type, none exhibited good predictive performance as a means of discriminating between these three infections (area under the receiver-operating characteristic curve < 0.70). After controlling for potential confounding variables, RSV infections in pneumonia patients were found to be associated with a 30-day mortality risk comparable to that of influenza patients [ odds ratio ( OR ) 1.016, 95% confidence interval ( CI ) 0.267–3.856, p = 0.982], whereas hMPV infection was associated with a reduced risk of mortality ( OR 0.144, 95% CI 0.027–0.780, p = 0.025). Among those without pneumonia, the 30-day mortality risk in patients with influenza was comparable to that in patients infected with RSV ( OR 1.268, 95% CI 0.172–9.355, p = 0.816) or hMPV ( OR 1.128, 95% CI 0.122–10.419, p = 0.916). Conclusion : Disease severity associated with these three types of viral infection was inconsistent when comparing patients with and without pneumonia, highlighting the importance of etiologic testing.