Leveraging Real-World Evidence to Define Severe RSV Lower Respiratory Tract Disease in Adults.

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES Infectious Diseases and Therapy Pub Date : 2024-11-16 DOI:10.1007/s40121-024-01072-4

Catherine A Panozzo, Edward E Walsh, Zhen Yang, Eleanor Wilson, Jaya Goswami, Sonia K Stoszek, Adrianna Loback, Tony Ng, Beverly M Francis, Alana K Simorellis, Wenmei Huang, Linwei Li, Rebecca Vislay-Wade, Zhe Zheng, Evan J Anderson, Allison August, Grace Chen, Ann R Falsey

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Abstract

Introduction: As no standard case definitions for respiratory syncytial virus-associated lower respiratory tract disease (RSV-LRTD) in adults are available, this study analyzed definitions for severe RSV-LRTD from previously published data in hospital and community cohorts of adults with RSV-associated symptoms.

Methods: The frequency, sensitivity, and specificity of acute respiratory disease symptoms among hospitalized and community cohorts of adults with RSV were analyzed. RSV-LRTD signs/symptoms assessed included shortness of breath (dyspnea), cough and/or fever, wheezing/rales/rhonchi (abnormal lung sounds by auscultation), sputum production, tachypnea, hypoxemia, and pleuritic chest pain.

Results: Dyspnea and tachypnea provided the best differentiation between hospitalized and community RSV-positive cases. The severe RSV-LRTD case definition yielding one of the highest and best-balanced sensitivity and specificity was dyspnea paired with either abnormal lung sounds by auscultation, hypoxemia, tachypnea, cough and/or fever, sputum, or chest pain.

Conclusions: Dyspnea alone, and in combination with certain other lower respiratory tract disease signs/symptoms, was a leading symptomatic indicator for severe RSV outcomes. These results contribute to the harmonization of case definitions for RSV disease.

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利用真实世界的证据定义成人严重 RSV 下呼吸道疾病。

导言：由于目前还没有成人呼吸道合胞病毒相关下呼吸道疾病（RSV-LRTD）的标准病例定义，本研究分析了以前发表的具有 RSV 相关症状的成人住院和社区队列数据中的严重 RSV-LRTD 定义：方法：分析了住院和社区队列成人 RSV 急性呼吸道疾病症状的频率、敏感性和特异性。评估的RSV-LRTD体征/症状包括呼吸急促（呼吸困难）、咳嗽和/或发热、喘鸣/哮鸣音/啰音（听诊肺部异常声音）、痰液分泌、呼吸过速、低氧血症和胸膜炎性胸痛：呼吸困难和呼吸急促是区分住院和社区 RSV 阳性病例的最佳方法。重症 RSV-LRTD 病例定义的灵敏度和特异性最高且最均衡，即呼吸困难与听诊异常肺音、低氧血症、呼吸过速、咳嗽和/或发热、痰液或胸痛同时出现：结论：呼吸困难本身以及与某些其他下呼吸道疾病体征/症状相结合，是严重 RSV 后果的主要症状指标。这些结果有助于统一 RSV 疾病的病例定义。

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来源期刊

Infectious Diseases and Therapy Medicine-Microbiology (medical)

CiteScore

8.60

自引率

1.90%

发文量

136

审稿时长

6 weeks

期刊介绍： Infectious Diseases and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of infectious disease therapies and interventions, including vaccines and devices. Studies relating to diagnostic products and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, bacterial and fungal infections, viral infections (including HIV/AIDS and hepatitis), parasitological diseases, tuberculosis and other mycobacterial diseases, vaccinations and other interventions, and drug-resistance, chronic infections, epidemiology and tropical, emergent, pediatric, dermal and sexually-transmitted diseases.