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Incidence of Respiratory Syncytial Virus Infection in Older Adults Before and During the COVID-19 Pandemic.
Juhn, Young J; Wi, Chung-Il; Takahashi, Paul Y; Ryu, Euijung; King, Katherine S; Hickman, Joel A; Yao, Joseph D; Binnicker, Matthew J; Natoli, Traci L; Evans, Tamara K; Sampathkumar, Priya; Patten, Christi; Luyts, Dominique; Pirçon, Jean-Yves; Damaso, Silvia; Pignolo, Robert J.
  • Juhn YJ; Department of Pediatric and Adolescent Medicine and Internal Medicine, Mayo Clinic, Rochester, Minnesota.
  • Wi CI; Department of Pediatric and Adolescent Medicine and Internal Medicine, Mayo Clinic, Rochester, Minnesota.
  • Takahashi PY; Division of Community Internal Medicine, Mayo Clinic, Rochester, Minnesota.
  • Ryu E; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota.
  • King KS; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota.
  • Hickman JA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota.
  • Yao JD; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
  • Binnicker MJ; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
  • Natoli TL; Department of Pediatric and Adolescent Medicine and Internal Medicine, Mayo Clinic, Rochester, Minnesota.
  • Evans TK; Department of Medicine Research, Mayo Clinic, Rochester, Minnesota.
  • Sampathkumar P; Division of Infectious Diseases, Mayo Clinic, Rochester, Minnesota.
  • Patten C; Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota.
  • Luyts D; GlaxoSmithKline, Wavre, Belgium.
  • Pirçon JY; GlaxoSmithKline, Wavre, Belgium.
  • Damaso S; GlaxoSmithKline, Wavre, Belgium.
  • Pignolo RJ; Divisions of Hospital Internal Medicine, Endocrinology, and Geriatric Medicine and Gerontology, Department of Medicine, Mayo Clinic, Rochester, Minnesota.
JAMA Netw Open ; 6(1): e2250634, 2023 Jan 03.
Article in English | MEDLINE | ID: covidwho-2208817
ABSTRACT
Importance Little is known about the burden and outcomes of respiratory syncytial virus (RSV)-positive acute respiratory infection (ARI) in community-dwelling older adults.

Objective:

To assess the incidence of RSV-positive ARI before and during the COVID-19 pandemic, and to assess outcomes for RSV-positive ARI in older adults. Design, Setting, and

Participants:

This was a community-based cohort study of adults residing in southeast Minnesota that followed up with 2325 adults aged 50 years or older for 2 RSV seasons (2019-2021) to assess the incidence of RSV-positive ARI. The study assessed outcomes at 2 to 4 weeks, 6 to 7 months, and 12 to 13 months after RSV-positive ARI. Exposure RSV-positive and -negative ARI. Main Outcomes and

Measures:

RSV status was the main study outcome. Incidence and attack rates of RSV-positive ARI were calculated during each RSV season, including before (October 2019 to April 2020) and during (October 2020 to April 2021) COVID-19 pandemic, and further calculated during non-RSV season (May to September 2021) for assessing impact of COVID-19. The self-reported quality of life (QOL) by Short-Form Health Survey-36 (SF-36) and physical functional measures (eg, 6-minute walk and spirometry) at each time point was assessed.

Results:

In this study of 2325 participants, the median (range) age of study participants was 67 (50-98) years, 1380 (59%) were female, and 2240 (96%) were non-Hispanic White individuals. The prepandemic incidence rate of RSV-positive ARI was 48.6 (95% CI, 36.9-62.9) per 1000 person-years with a 2.50% (95% CI, 1.90%-3.21%) attack rate. No RSV-positive ARI case was identified during the COVID-19 pandemic RSV season. Incidence of 10.2 (95% CI, 4.1-21.1) per 1000 person-years and attack rate of 0.42%; (95% CI, 0.17%-0.86%) were observed during the summer of 2021. Based on prepandemic RSV season results, participants with RSV-positive ARI (vs matched RSV-negative ARI) reported significantly lower QOL adjusted mean difference (limitations due to physical health, -16.7 [95% CI, -31.8 to -1.8]; fatigue, -8.4 [95% CI, -14.3 to -2.4]; and difficulty in social functioning, -11.9 [95% CI, -19.8 to -4.0] within 2 to 4 weeks after RSV-positive ARI [ie, short-term outcome]). Compared with participants with RSV-negative ARI, those with RSV-positive ARI also had lower QOL (fatigue -4.0 [95% CI, -8.5 to -1.3]; difficulty in social functioning, -5.8 [95% CI, -10.3 to -1.3]; and limitation due to emotional problem, -7.0 [95% CI, -12.7 to -1.3] at 6 to 7 months after RSV-positive ARI [intermediate-term outcome]; fatigue, -4.4 [95% CI, -7.3 to -1.5]; difficulty in social functioning, -5.2 [95% CI, -8.7 to -1.7] and limitation due to emotional problem, -5.7 [95% CI, -10.7 to -0.6] at 12-13 months after RSV-positive ARI [ie, long-term outcomes]) independent of age, sex, race and/or ethnicity, socioeconomic status, and high-risk comorbidities. Conclusions and Relevance In this cohort study, the burden of RSV-positive ARI in older adults during the pre-COVID-19 period was substantial. After a reduction of RSV-positive ARI incidence from October 2020 to April 2021, RSV-positive ARI re-emerged during the summer of 2021. RSV-positive ARI was associated with significant long-term lower QOL beyond the short-term lower QOL in older adults.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Tract Infections / Respiratory Syncytial Virus Infections / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male Language: English Journal: JAMA Netw Open Year: 2023 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Tract Infections / Respiratory Syncytial Virus Infections / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Aged / Female / Humans / Male Language: English Journal: JAMA Netw Open Year: 2023 Document Type: Article