Fiona P. Havers , Michael Whitaker , Michael Melgar , Bhoomija Chatwani , Shua J. Chai , Nisha B. Alden , James Meek , Kyle P. Openo , Patricia A. Ryan , Sue Kim , Ruth Lynfield , Yomei P. Shaw , Grant Barney , Brenda L. Tesini , Melissa Sutton , H. Keipp Talbot , Kristen P. Olsen , Monica E. Patton
{"title":"2022年7月至2023年6月,12个州,因实验室确认的呼吸道合胞病毒-RRSV-NET住院的≥60岁成年人的特征和结果。","authors":"Fiona P. Havers , Michael Whitaker , Michael Melgar , Bhoomija Chatwani , Shua J. Chai , Nisha B. Alden , James Meek , Kyle P. Openo , Patricia A. Ryan , Sue Kim , Ruth Lynfield , Yomei P. Shaw , Grant Barney , Brenda L. Tesini , Melissa Sutton , H. Keipp Talbot , Kristen P. Olsen , Monica E. Patton","doi":"10.1016/j.ajt.2023.10.010","DOIUrl":null,"url":null,"abstract":"<div><p>Respiratory syncytial virus (RSV) causes substantial morbidity and mortality in older adults. In May 2023, two RSV vaccines were approved for prevention of RSV lower respiratory tract disease in adults aged ≥60 years. In June 2023, CDC recommended RSV vaccination for adults aged ≥60 years, using shared clinical decision-making. Using data from the Respiratory Syncytial Virus–Associated Hospitalization Surveillance Network, a population-based hospitalization surveillance system operating in 12 states, this analysis examined characteristics (including age, underlying medical conditions, and clinical outcomes) of 3,218 adults aged ≥60 years who were hospitalized with laboratory-confirmed RSV infection during July 2022–June 2023. Among a random sample of 1,634 older adult patients with RSV-associated hospitalization, 54.1% were aged ≥75 years, and the most common underlying medical conditions were obesity, chronic obstructive pulmonary disease, congestive heart failure, and diabetes. Severe outcomes occurred in 18.5% (95% CI = 15.9%–21.2%) of hospitalized patients aged ≥60 years. Overall, 17.0% (95% CI = 14.5%–19.7%) of patients with RSV infection were admitted to an intensive care unit, 4.8% (95% CI = 3.5%–6.3%) required mechanical ventilation, and 4.7% (95% CI = 3.6%–6.1%) died; 17.2% (95% CI = 14.9%–19.8%) of all cases occurred in long-term care facility residents. These data highlight the importance of prioritizing those at highest risk for severe RSV disease and suggest that clinicians and patients consider age (particularly age ≥75 years), long-term care facility residence, and underlying medical conditions, including chronic obstructive pulmonary disease and congestive heart failure, in shared clinical decision-making when offering RSV vaccine to adults aged ≥60 years.</p></div>","PeriodicalId":123,"journal":{"name":"American Journal of Transplantation","volume":"23 12","pages":"Pages 2000-2007"},"PeriodicalIF":8.9000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1600613523008006/pdfft?md5=3472452094960511e550d6daafb72e06&pid=1-s2.0-S1600613523008006-main.pdf","citationCount":"1","resultStr":"{\"title\":\"Characteristics and Outcomes Among Adults Aged ≥60 Years Hospitalized with Laboratory-Confirmed Respiratory Syncytial Virus — RSV-NET, 12 States, July 2022–June 2023\",\"authors\":\"Fiona P. Havers , Michael Whitaker , Michael Melgar , Bhoomija Chatwani , Shua J. Chai , Nisha B. Alden , James Meek , Kyle P. Openo , Patricia A. Ryan , Sue Kim , Ruth Lynfield , Yomei P. Shaw , Grant Barney , Brenda L. Tesini , Melissa Sutton , H. Keipp Talbot , Kristen P. Olsen , Monica E. Patton\",\"doi\":\"10.1016/j.ajt.2023.10.010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><p>Respiratory syncytial virus (RSV) causes substantial morbidity and mortality in older adults. In May 2023, two RSV vaccines were approved for prevention of RSV lower respiratory tract disease in adults aged ≥60 years. In June 2023, CDC recommended RSV vaccination for adults aged ≥60 years, using shared clinical decision-making. Using data from the Respiratory Syncytial Virus–Associated Hospitalization Surveillance Network, a population-based hospitalization surveillance system operating in 12 states, this analysis examined characteristics (including age, underlying medical conditions, and clinical outcomes) of 3,218 adults aged ≥60 years who were hospitalized with laboratory-confirmed RSV infection during July 2022–June 2023. Among a random sample of 1,634 older adult patients with RSV-associated hospitalization, 54.1% were aged ≥75 years, and the most common underlying medical conditions were obesity, chronic obstructive pulmonary disease, congestive heart failure, and diabetes. Severe outcomes occurred in 18.5% (95% CI = 15.9%–21.2%) of hospitalized patients aged ≥60 years. Overall, 17.0% (95% CI = 14.5%–19.7%) of patients with RSV infection were admitted to an intensive care unit, 4.8% (95% CI = 3.5%–6.3%) required mechanical ventilation, and 4.7% (95% CI = 3.6%–6.1%) died; 17.2% (95% CI = 14.9%–19.8%) of all cases occurred in long-term care facility residents. These data highlight the importance of prioritizing those at highest risk for severe RSV disease and suggest that clinicians and patients consider age (particularly age ≥75 years), long-term care facility residence, and underlying medical conditions, including chronic obstructive pulmonary disease and congestive heart failure, in shared clinical decision-making when offering RSV vaccine to adults aged ≥60 years.</p></div>\",\"PeriodicalId\":123,\"journal\":{\"name\":\"American Journal of Transplantation\",\"volume\":\"23 12\",\"pages\":\"Pages 2000-2007\"},\"PeriodicalIF\":8.9000,\"publicationDate\":\"2023-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S1600613523008006/pdfft?md5=3472452094960511e550d6daafb72e06&pid=1-s2.0-S1600613523008006-main.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Transplantation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1600613523008006\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Transplantation","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1600613523008006","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Characteristics and Outcomes Among Adults Aged ≥60 Years Hospitalized with Laboratory-Confirmed Respiratory Syncytial Virus — RSV-NET, 12 States, July 2022–June 2023
Respiratory syncytial virus (RSV) causes substantial morbidity and mortality in older adults. In May 2023, two RSV vaccines were approved for prevention of RSV lower respiratory tract disease in adults aged ≥60 years. In June 2023, CDC recommended RSV vaccination for adults aged ≥60 years, using shared clinical decision-making. Using data from the Respiratory Syncytial Virus–Associated Hospitalization Surveillance Network, a population-based hospitalization surveillance system operating in 12 states, this analysis examined characteristics (including age, underlying medical conditions, and clinical outcomes) of 3,218 adults aged ≥60 years who were hospitalized with laboratory-confirmed RSV infection during July 2022–June 2023. Among a random sample of 1,634 older adult patients with RSV-associated hospitalization, 54.1% were aged ≥75 years, and the most common underlying medical conditions were obesity, chronic obstructive pulmonary disease, congestive heart failure, and diabetes. Severe outcomes occurred in 18.5% (95% CI = 15.9%–21.2%) of hospitalized patients aged ≥60 years. Overall, 17.0% (95% CI = 14.5%–19.7%) of patients with RSV infection were admitted to an intensive care unit, 4.8% (95% CI = 3.5%–6.3%) required mechanical ventilation, and 4.7% (95% CI = 3.6%–6.1%) died; 17.2% (95% CI = 14.9%–19.8%) of all cases occurred in long-term care facility residents. These data highlight the importance of prioritizing those at highest risk for severe RSV disease and suggest that clinicians and patients consider age (particularly age ≥75 years), long-term care facility residence, and underlying medical conditions, including chronic obstructive pulmonary disease and congestive heart failure, in shared clinical decision-making when offering RSV vaccine to adults aged ≥60 years.
期刊介绍:
The American Journal of Transplantation is a leading journal in the field of transplantation. It serves as a forum for debate and reassessment, an agent of change, and a major platform for promoting understanding, improving results, and advancing science. Published monthly, it provides an essential resource for researchers and clinicians worldwide.
The journal publishes original articles, case reports, invited reviews, letters to the editor, critical reviews, news features, consensus documents, and guidelines over 12 issues a year. It covers all major subject areas in transplantation, including thoracic (heart, lung), abdominal (kidney, liver, pancreas, islets), tissue and stem cell transplantation, organ and tissue donation and preservation, tissue injury, repair, inflammation, and aging, histocompatibility, drugs and pharmacology, graft survival, and prevention of graft dysfunction and failure. It also explores ethical and social issues in the field.