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Recto C, Fourati S, Khellaf M, Pawlotsky JM, De Prost N, Diakonoff H, Donadio C, Pouga L, de Tymowski C, Kassasseya C. Respiratory syncytial virus vs. Influenza virus infection: mortality and morbidity comparison over 7 epidemic seasons in an elderly population. J Infect Dis 2024:jiae171. [PMID: 38574192 DOI: 10.1093/infdis/jiae171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 03/06/2024] [Accepted: 03/28/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Respiratory syncytial virus (RSV) infection is gaining interest due to the recent development of vaccines, but it is still misdiagnosed in the elderly. The primary objective was to compare all-cause mortality at day 30. Secondary objectives were to compare clinical presentation, and rates of consolidative pneumonia, hospitalization, and intensive care unit (ICU) admission. METHODS Single-centre retrospective study conducted in a French university hospital during 7 epidemic seasons. All patients aged ≥75 years were included. RESULTS 558 patients were included: 125 with RSV and 433 with Influenza. Median age was 84.8 years. RSV patients had more respiratory symptoms (wheezing, dyspnea), whereas Influenza patients had more general symptoms (fever, asthenia, myalgia). Consolidative pneumonia (28.8% vs. 17.2%; p = 0.004), hospitalization rates (83.2% vs. 70%; p = 0.003), ICU admissions (7.2% vs. 3.0%; p = 0.034) and length of stay (9 days [2-16] vs. 5 days [0-12]; p = 0.002), were higher in the RSV group. Mortality rates at day 30 were comparable (RSV 9.6%, Influenza 9.7%; p = 0.973). CONCLUSIONS This study included the largest cohort of RSV-infected patients aged over 75, documented in-depth thus far. RSV shares a comparable mortality rate with Influenza but is associated with higher rates of consolidative pneumonia, hospitalization, ICU admissions, and extended hospital stays.
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Affiliation(s)
- C Recto
- AP-HP, Henri Mondor University Hospital, Department of Internal Medicine and Geriatrics, F-94010 Creteil's Paris-Est University, Creteil, France
| | - S Fourati
- Virology Department, Henri Mondor University Hospital, Paris-Est University and INSERM U955. Creteil's Paris-Est University, Creteil, France
| | - M Khellaf
- Emergency Department, APHP, Henri Mondor University Hospital, Paris EST Creteil University, Creteil, France
| | - J-M Pawlotsky
- Virology Department, Henri Mondor University Hospital, Paris-Est University and INSERM U955. Creteil's Paris-Est University, Creteil, France
| | - N De Prost
- Service de Medecine Intensive Reanimation, Hopitaux Universitaires Henri Mondor - Albert Chenevier, Assistance Publique-Hopitaux de Paris (AP-HP), 94010, Creteil, France
- Groupe de Recherche Clinique CARMAS, Creteil's Paris-Est University, Creteil, France
| | - H Diakonoff
- Institution Nationale des Invalides, Paris, France. Institut Droit et Santé, Inserm UMR_S 1145, Université Paris Cité, France
| | - C Donadio
- University Hospital Pitié-Salpêtrière- Charles Foix, Geriatric's Department, AP-HP, Sorbonne University, Paris, France
| | - L Pouga
- Virology Department, Henri Mondor University Hospital, Paris-Est University and INSERM U955. Creteil's Paris-Est University, Creteil, France
| | - C de Tymowski
- Department of Anaesthesiology and Surgical Intensive Care, DMU PARABOL, AP-HP, Hôpital Bichat, F-75018 Paris, France
| | - C Kassasseya
- Emergency Department, APHP, Henri Mondor University Hospital, Paris EST Creteil University, Creteil, France
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Unniachan S, Bash LD, Khovidhunkit W, Sri RZT, Vicaldo E, Recto C, Ambegaonkar BM. Prevalence of lipid abnormalities and attainment of normal lipid levels among patients with dyslipidaemia: a pooled analysis of observational studies from five Asian countries. Int J Clin Pract 2014; 68:1010-9. [PMID: 24666791 DOI: 10.1111/ijcp.12407] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
AIMS Guidelines emphasise the importance of low-density lipoprotein cholesterol (LDL-C) goals for cardiovascular risk reduction. Given the importance of association between high-density lipoprotein (HDL-C) and triglycerides (TG) normal levels and cardiovascular risk, there is an additional need to further evaluate diverse dyslipidaemic populations. METHODS A retrospective longitudinal observational study of patients aged ≥ 35 years on lipid-modifying therapy (LMT) for ≥ 12 months was conducted from patient records pooled from five Asian countries (Malaysia, Korea, Hong Kong, Thailand and Philippines). The prevalence of lipid abnormalities and goal attainment was assessed 12 months before and after LMT initiation. RESULTS Among 3256 patients (mean age - 58.6 years, 50.4% men), 65.4% were high-risk patients and 88% were on statin therapy. At baseline 94.7% of all patients had at least one abnormal lipid value elevated, LDL-C (86.2%) being the most prevalent. Non-smokers [OR (95% CI): 1.42 (1.08-1.87)], non-diabetics [2.35 (1.96-2.82)], non-cardiovascular disease patients [1.77 (1.42-2.21)] and those from Korea [2.56 (1.83-3.59)] were more likely to attain LDL-C goals. On the contrary, women [0.82 (0.68-0.98)], subjects with FRS > 20% [0.56 (0.41-0.77)] those from Malaysia [0.55 (0.39-0.77)] and the Philippines [0.18 (0.12-0.28)] were less likely to reach LDL-C goals. Fewer characteristics were independently associated with reaching normal levels of HDL-C and TG and attaining at least two normal lipid levels. CONCLUSIONS While current LMT reduced the prevalence of dyslipidaemia, a third of patients still failed to achieve target/normal levels. We highlight country differences and the importance of improving therapy to attain multiple lipid goals/normal levels.
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Affiliation(s)
- S Unniachan
- School of Public Health, UMDNJ, Piscataway, NJ, USA
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