A Study on Clinical Features of Respiratory Syncytial Virus in Acute Respiratory Tract Infection in Elderly Hospitalized Patients in Winter

TL;DR

This study examines the clinical features of respiratory syncytial virus (RSV) in elderly hospitalized patients with acute respiratory infections during winter in China.

Contribution

The study provides insights into RSV infection patterns and clinical manifestations in elderly patients, a group underrepresented in prior research.

Findings

RSV infection in elderly patients was associated with high rates of comorbidities and severe symptoms like cough, sputum, and dyspnea.

Elevated CRP, lymphopenia, and respiratory failure were common laboratory findings among RSV-infected elderly patients.

The study found a high discharge rate (93.33%) but a notable mortality rate (6.67%) among hospitalized elderly RSV patients.

Abstract

Respiratory syncytial virus (RSV) is one of the important pathogens found in patients with acute respiratory infection (ARI), but there are few studies on RSV infection among elderly people in China.

This study collected data on the RSV‐infected population among the hospitalized patients with ARI admitted to the Department of Respiratory Medicine of our hospital from November 2023 to February 2024 and analyzed the clinical data of the elderly (≥ 60 years old) grouped by age. Patients admitted to other departments (e.g., general internal medicine, geriatrics) were not included, potentially introducing selection bias toward more severe respiratory presentations.

The total infection rate was 12.16%, and the main symptoms were cough (97.78%), sputum (95.56%), and dyspnea (68.89%); 100% of the patients had comorbidity, and 97.78% of the patients had two or more comorbidities. Laboratory findings were mainly elevated CRP (84.4%), lymphopenia (64.44%), elevated hs‐cTni (51.11%), elevated N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) (37.78%), decreased PaO2 (88.89%), and elevated PaCO2 (44.44%). The rate of mixed bacterial and viral infection was 37.78%; 95.56% of the patients had lung imaging changes; 100% of the patients received respiratory therapy support, and 91.11% of the patients used antibiotics. The discharge rate was 93.33%, and the mortality rate was 6.67%.

There was no obvious abnormal seasonality in the infection rate; the infection rate, the proportion of lymphopenia, and the proportion of respiratory failure were higher than in most other studies. The statistical data are only statistically significant in terms of the decrease in PaO2/FiO2 (P/F ratio), the elevation in the NT‐proBNP, and some imaging performances. It may be that the number of samples is not large enough to cause the difference to be insignificant. Furthermore, this study exclusively included patients admitted to the Respiratory Medicine Department, which may reflect department‐specific referral bias and potentially underestimate the true burden of RSV in the broader elderly population. Patients admitted to other departments (e.g., general internal medicine, geriatrics) were not included, potentially introducing selection bias toward more severe respiratory presentations.