RSV Disease Burden in Older Adults: An Italian Multiregion Pilot Study of Acute Respiratory Infections in Primary Care Setting, Winter Season 2022–2023

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES Influenza and Other Respiratory Viruses Pub Date : 2024-11-26 DOI:10.1111/irv.70049

Sara Bracaloni, Enrica Esposito, Michela Scarpaci, Tommaso Cosci, Beatrice Casini, Federica Chiovelli, Guglielmo Arzilli, Mauro Pistello, Donatella Panatto, Matilde Ogliastro, Daniela Loconsole, Maria Chironna, Caterina Rizzo, RSVComNet Italy

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Abstract

Background

Respiratory syncytial virus (RSV) is a major cause of hospital admission in adults over 65, leading to severe complications and death. However, the disease burden in primary care for older adults in Europe is poorly understood. This pilot study aims to test a study protocol for evaluating the clinical burden of RSV in older adults in primary care settings in Italy.

Methods

In the 2022–23 winter season, we designed a study on RSV burden in individuals over 65 with acute respiratory infections (ARIs) in Liguria, Apulia, and Tuscany, Italy. Recruited patients underwent nasopharyngeal swabs for RSV confirmation and provided epidemiological and clinical data. RSV-positive patients completed follow-up questionnaires after 14 and 30 days regarding their clinical conditions, healthcare utilization, and socio-economic impact.

Results

We enrolled 152 patients with ARIs; 33 (21.7%) tested positive for RSV. The median disease duration was 14 days, with 3% hospitalized. Among RSV-positive patients, 87% received drug treatment, 52% of whom received antibiotics. After diagnosis, 74% required further GP consultations within 2 weeks. Additionally, 48% incurred extra costs. On day 30, 21% reported health complications or deterioration.

Conclusions

Our pilot study highlights the need for an ARIs surveillance system for older adults in primary care. This is crucial for defining vaccination strategies to reduce the disease burden on these patients and the healthcare system. Moreover, these data are essential for assessing costs and parameters for cost-effectiveness models, facilitating informed decisions in public health planning and resource allocation.

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老年人 RSV 疾病负担：意大利多地区基层医疗机构急性呼吸道感染试点研究（2022-2023 年冬季

背景呼吸道合胞病毒（RSV）是 65 岁以上成年人入院治疗的主要原因，可导致严重并发症和死亡。然而，人们对欧洲老年人初级保健的疾病负担知之甚少。这项试点研究旨在测试一项研究方案，以评估意大利基层医疗机构中老年人 RSV 的临床负担。方法在 2022-23 年冬季，我们设计了一项关于意大利利古里亚、阿普利亚和托斯卡纳 65 岁以上急性呼吸道感染 (ARI) 患者 RSV 负担的研究。被招募的患者接受了鼻咽拭子检查以确认 RSV，并提供了流行病学和临床数据。RSV 阳性患者在 14 天和 30 天后填写了有关其临床状况、医疗保健使用情况和社会经济影响的随访问卷。结果我们共招募了 152 名急性呼吸道感染患者，其中 33 人（21.7%）的 RSV 检测结果呈阳性。中位病程为 14 天，3% 的患者住院治疗。在 RSV 阳性患者中，87% 接受了药物治疗，其中 52% 接受了抗生素治疗。确诊后，74%的患者需要在两周内进一步咨询全科医生。此外，48%的患者还产生了额外费用。第 30 天，21% 的患者报告出现健康并发症或病情恶化。结论我们的试点研究强调了在初级保健中为老年人建立急性呼吸道感染监控系统的必要性。这对于确定疫苗接种策略以减轻这些患者和医疗系统的疾病负担至关重要。此外，这些数据对于评估成本和成本效益模型参数至关重要，有助于在公共卫生规划和资源分配方面做出明智的决策。

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来源期刊

Influenza and Other Respiratory Viruses 医学-病毒学

CiteScore

7.20

自引率

4.50%

发文量

120

审稿时长

6-12 weeks

期刊介绍： Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.