Severity of respiratory syncytial virus versus SARS-CoV-2 Omicron and influenza infection amongst hospitalized Singaporean adults: a national cohort study.

• Tác giả: David Chien Boon Lye, Hau Yiang Cheong, Calvin J Chiew, Reen Wan Li Ho, Jue Tao Lim, Tong Yong Ng, Jean Xiang Ying Sim, Kelvin Bryan Tan, Indumathi Venkatachalam, Liang En Wee, Barnaby Young, Chee-Fu Yung
• Ngôn ngữ: eng
• Ký hiệu phân loại: 363.732 Incidence, extent, severity
• Thông tin xuất bản: England : The Lancet regional health. Western Pacific , 2025
• Bộ sưu tập: NCBI
• ID: 89657

Tóm tắt

 BACKGROUND: More data is required to contextualise respiratory-syncytial-virus (RSV) disease burden, versus other vaccine-preventable respiratory-viral-infections (RVIs) in older adults. We aimed to compare severity of RSV in hospitalized adults versus influenza/boosted COVID-19. METHODS: Retrospective population-based cohort study, including all adult RSV hospitalizations (2021-2023) in Singapore. Disease severity (28-day mortality/intensive-care-unit [ICU] admission) and healthcare utilization in RSV hospitalizations were compared with contemporaneous influenza hospitalizations and COVID-19 hospitalizations in 2023. Outcomes for COVID-19 were stratified by type/receipt of boosters. Comparative severity of RSV versus COVID-19/influenza was evaluated using multivariate logistic regression, adjusted for confounders. Generalized linear models were utilized to estimate excess length-of-stay/costs of RSV hospitalization versus COVID-19/influenza as a rate-ratio. FINDINGS: 12,811 hospitalized adults were included (RSV: N = 1332
  influenza: N = 3999
  COVID-19: N = 7480). Amongst RSV hospitalizations, 5.4% (72/1332) died within 28 days
  3.8% (51/1332) required ICU. Median length-of-stay (RSV) was 5.0 days (IQR = 3.0-8.0). Older age/diabetes were associated with greater odds of 28-day mortality in RSV hospitalizations. Higher odds of 28-day mortality/ICU admission and higher healthcare utilization was observed in RSV hospitalizations versus influenza. Conversely, RSV was less severe than unboosted COVID-19, with lower odds of 28-day mortality (adjusted-odds-ratio, aOR = 0.56 [95% CI = 0.40-0.79]) and rate-ratio for length-of-stay/costs significantly <
 1. However, higher odds of ICU (aOR = 1.80 [95% CI = 1.07-3.00]) were observed in RSV hospitalizations, versus COVID-19 hospitalizations boosted <
 1 year prior with updated vaccines. INTERPRETATION: Hospitalizations attributed to RSV were more severe than influenza. RSV disease was less severe versus COVID-19 in unboosted patients but severity was not significantly different from COVID-19 in boosted individuals. FUNDING: National Medical Research Council, Singapore.