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Background <p>Comparative data on the disease burden of respiratory syncytial virus (RSV) versus other respiratory viruses in adults with chronic lung disease (CLD; asthma, COPD, or bronchiectasis) remain limited. This study aimed to compare clinical outcomes associated with RSV, influenza, and SARS-CoV-2 in this population during a period that largely preceded widespread adult RSV vaccine uptake.</p> Methods <p>Adult patients diagnosed with CLD and confirmed to have RSV, influenza, or Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection through combo tests including polymerase chain reaction or rapid antigen testing from June 2022 to April 2024 were included. A total of 82,871 participants diagnosed with CLD who tested positive for RSV, influenza, or SARS-CoV-2 using combo tests were included in the analysis. Patients with co-existing viral infections were excluded. Short-term adverse outcomes were defined as events occurring within 28 days after the index date, while long-term adverse outcomes were defined as events that occurred between 12 to 52 weeks.</p> Results <p>After propensity score matching, RSV-infected patients had higher rates of exacerbations compared to those with influenza (HR:1.37, 95% CI:1.28–1.47) and those with SARS-CoV-2 (HR:2.98, 95% CI:2.73–3.26). These patients also showed an increased requirement for mechanical ventilation compared to those with influenza (HR:1.50, 95% CI:1.29–1.75) and those with SARS-CoV-2 (HR:1.97, 95% CI:1.67–2.33). Additionally, RSV-infected individuals experienced higher incidences of acute decompensated heart failure compared to influenza (HR:1.32, 95% CI:1.20–1.46), and (HR:1.46, 95% CI:1.32–1.61) relative to SARS-CoV-2, respectively. </p> Conclusions <p>RSV infection in patients with CLD revealed higher disease severity compared to influenza and SARS-CoV-2, warranting increased clinical attention for this population.</p> Summary <p>In this national cohort spanning June 2022 to March 2024, adults with chronic lung disease contracting RSV, influenza or SARS-CoV-2 were analyzed. Relative to the other viruses, RSV infection led to higher emergency visits, hospitalizations and mechanical ventilation, highlighting an urgent prevention gap.</p>

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Respiratory syncytial virus is associated with a higher disease burden than influenza and SARS-CoV-2 in adults with chronic lung disease: a multi-center cohort study

  • 期刊论文

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  • 发表日期：

    2026年2月9日

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  • Chuan-Yen Sun,
  • Chuan Angel Lu,
  • Craig P. Hersh,
  • Yee Hui Yeo,
  • Po-Yang Tsou,
  • Shiow-Ing Wang,
  • Kun-Ta Chou,
  • Kuang-Yao Yang,
  • Yi-Jin Tina Hsieh,
  • James Chung-Chung Wei,
  • Gin Yi Lee

摘要

Background

Comparative data on the disease burden of respiratory syncytial virus (RSV) versus other respiratory viruses in adults with chronic lung disease (CLD; asthma, COPD, or bronchiectasis) remain limited. This study aimed to compare clinical outcomes associated with RSV, influenza, and SARS-CoV-2 in this population during a period that largely preceded widespread adult RSV vaccine uptake.

Methods

Adult patients diagnosed with CLD and confirmed to have RSV, influenza, or Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection through combo tests including polymerase chain reaction or rapid antigen testing from June 2022 to April 2024 were included. A total of 82,871 participants diagnosed with CLD who tested positive for RSV, influenza, or SARS-CoV-2 using combo tests were included in the analysis. Patients with co-existing viral infections were excluded. Short-term adverse outcomes were defined as events occurring within 28 days after the index date, while long-term adverse outcomes were defined as events that occurred between 12 to 52 weeks.

Results

After propensity score matching, RSV-infected patients had higher rates of exacerbations compared to those with influenza (HR:1.37, 95% CI:1.28–1.47) and those with SARS-CoV-2 (HR:2.98, 95% CI:2.73–3.26). These patients also showed an increased requirement for mechanical ventilation compared to those with influenza (HR:1.50, 95% CI:1.29–1.75) and those with SARS-CoV-2 (HR:1.97, 95% CI:1.67–2.33). Additionally, RSV-infected individuals experienced higher incidences of acute decompensated heart failure compared to influenza (HR:1.32, 95% CI:1.20–1.46), and (HR:1.46, 95% CI:1.32–1.61) relative to SARS-CoV-2, respectively.

Conclusions

RSV infection in patients with CLD revealed higher disease severity compared to influenza and SARS-CoV-2, warranting increased clinical attention for this population.

Summary

In this national cohort spanning June 2022 to March 2024, adults with chronic lung disease contracting RSV, influenza or SARS-CoV-2 were analyzed. Relative to the other viruses, RSV infection led to higher emergency visits, hospitalizations and mechanical ventilation, highlighting an urgent prevention gap.