Characteristics and Outcomes of Patients in the ICU With Respiratory Syncytial Virus Compared With Those With Influenza Infection,Chest

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Characteristics and Outcomes of Patients in the ICU With Respiratory Syncytial Virus Compared With Those With Influenza Infection
Chest ( IF 9.5 ) Pub Date : 2022-01-19 , DOI: 10.1016/j.chest.2021.12.670
Julien Coussement ₁ , Benjamin Zuber ₂ , Eve Garrigues ₃ , Antoine Gros ₄ , Charlotte Vandueren ₅ , Nicolas Epaillard ₆ , Guillaume Voiriot ₇ , Yacine Tandjaoui-Lambiotte ₈ , Jean-Baptiste Lascarrou ₉ , Florence Boissier ₁₀ , Virginie Lemiale ₁₁ , Damien Contou ₁₂ , Sami Hraiech ₁₃ , Anne-Pascale Meert ₁₄ , Bertrand Sauneuf ₁₅ , Aline Munting ₁₆ , Sylvie Ricome ₁₇ , Jonathan Messika ₁₈ , Gregoire Muller ₁₉ , Hassane Njimi ₅ , David Grimaldi ₅

Affiliation

Department of Infectious Diseases, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
Intensive Care Unit, Hôpital Foch, Suresnes, France.
Médecine Intensive Réanimation, CHU Ambroise Paré, Boulogne-Billancourt, France.
Intensive Care Unit, Centre Hospitalier de Versailles, Le Chesnay, France.
Intensive Care Unit, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.
Service de Réanimation Médicale, Hopital Saint Antoine, Paris, France.
Sorbonne Université, Service de Médecine Intensive Réanimation, Hôpital Tenon, Paris, France.
Service de Réanimation Médico-Chirurgicale, CHU Avicenne, Assistance Publique-Hôpitaux de Paris, France; INSERM U1272 Hypoxie & Poumon, Bobigny, France.
Médecine Intensive Réanimation, CHU de Nantes, Nantes, France.
Service de Médecine Intensive Réanimation, CHU de Poitiers, Poitiers, France; INSERM CIC 1402 (ALIVE group), Université de Poitiers, Poitiers, France.
Medical Intensive Care Unit, Saint Louis University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Réanimation Polyvalente, Centre Hospitalier Victor Dupouy, Argenteuil, France.
Assistance Publique-Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, Marseille, France; Centre d'Études et de Recherches sur les Services de Santé et Qualité de Vie EA 3279, Marseille, France.
Service de Médecine Interne, Soins Intensifs & Urgences Oncologiques, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Intensive Care Unit, Centre Hospitalier Public du Cotentin, Cherbourg-en-Cotentin, France.
Department of Infectious Diseases, CHU UCL Namur, Yvoir, Belgium.
Service de Réanimation Polyvalente, Centre Hospitalier Robert Ballanger, Aulnay-sous-Bois, France.
Université de Paris, Assistance Publique-Hôpitaux de Paris, Hôpital Louis Mourier, DMU ESPRIT, PHERE UMRS 1152, INSERM, Paris, France.
Medical Intensive Care Unit, Centre Hospitalier Régional d'Orléans, Orléans, France.

Background

The characteristics and outcomes of adult patients with respiratory syncytial virus (RSV) infection who require ICU admission are poorly defined. Although several studies in adults with RSV infection have been published in recent years, they did not focus specifically on patients with critical illness.

Research Question

What are the characteristics and outcomes of adult patients in the ICU with RSV infection and how do they compare with those of patients in the ICU with influenza infection?

Study Design and Methods

This retrospective, multicenter study in France and Belgium (17 sites) compared the characteristics and outcomes of adult patients in the ICU with RSV infection vs those with influenza infection between November 2011 and April 2018. Each patient with RSV infection was matched by institution and date of diagnosis with a patient with influenza infection. In-hospital mortality was compared between the two groups, with adjustment for prognostic factors in a multivariate model (sex, age, main underlying conditions, and concurrent bloodstream infection).

Results

Data from 618 patients (309 with RSV infection and 309 with influenza infection) were analyzed. Patients with RSV infection were significantly more likely to have an underlying chronic respiratory condition (60.2% vs 40.1%; P < .001) and to be immunocompromised (35% vs 26.2%; P = .02) than patients with influenza infection. Several differences in clinical signs and biological data at diagnosis were found between the groups. In-hospital mortality was not significantly different between the two groups (23.9% in the RSV group vs 25.6% in the influenza group; P = .63), even after adjustment for prognostic factors in a multivariate model.

Interpretation

Adult patients in the ICU with RSV infection differ from adult patients in the ICU with influenza in terms of comorbidities and characteristics at diagnosis. RSV infection was associated with high in-hospital mortality, approaching 25%. In multivariate analysis, RSV infection was associated with a similar odds of in-hospital death compared with influenza infection.

中文翻译：

ICU呼吸道合胞病毒患者与流感感染患者的特征和结局比较

背景

需要入住 ICU 的呼吸道合胞病毒 (RSV) 感染成人患者的特征和结局尚不明确。尽管近年来已经发表了几项针对 RSV 感染成人的研究，但它们并没有特别关注危重病患者。

研究问题

ICU 中感染 RSV 的成年患者有哪些特征和结局，与 ICU 中感染流感病毒的患者相比如何？

研究设计和方法

这项在法国和比利时（17 个地点）进行的回顾性、多中心研究比较了 2011 年 11 月至 2018 年 4 月期间 ICU 中 RSV 感染与流感感染的成年患者的特征和结果。每位 RSV 感染患者均按机构和日期进行匹配流感感染患者的诊断。比较两组的住院死亡率，并在多变量模型中调整预后因素（性别、年龄、主要潜在疾病和并发血流感染）。

结果

分析了来自 618 名患者（309 名 RSV 感染和 309 名流感感染）的数据。与流感感染患者相比，RSV 感染患者出现潜在慢性呼吸系统疾病（60.2% 对 40.1%；P < .001）和免疫功能低下（35% 对 26.2%；P = .02）的可能性显着增加。各组之间在诊断时发现临床体征和生物学数据存在若干差异。即使在多变量模型中调整了预后因素后，两组的住院死亡率也没有显着差异（RSV 组为 23.9%，流感组为 25.6%；P = 0.63）。