Excess mortality following community-onset norovirus enteritis in the elderly

J Hosp Infect. 2011 Sep;79(1):27-31. doi: 10.1016/j.jhin.2011.05.018. Epub 2011 Jul 20.

Abstract

Norovirus has been associated with excess deaths. A retrospective study of mortality following norovirus enteritis (NVE) was undertaken. All hospitalized adult patients with a stool sample positive for norovirus genogroup II on polymerase chain reaction, treated at Sahlgrenska University Hospital, Gothenburg, Sweden between August 2008 and June 2009, were included as cases (N = 598, aged 18-101 years). Matched controls without enteritis (N = 1196) were selected for comparison. Medical records were reviewed and deaths up to 90 days following positive sampling were noted, as well as comorbidities and length of hospital stay. Thirty- and 90-day survival rates were calculated. Total 30-day mortality was 7.6% and no deaths were recorded in cases aged 18-59 years. Thirty-day mortality was higher in cases with underlying medical conditions compared with those without these comorbidities (age 60-101 years: 89.5% vs 94.7% alive at Day 30, respectively; P < 0.05). In cases aged > 80 years, mortality was higher in those with community-onset NVE (N = 64) compared with hospital-onset NVE (N = 305) (81.2% vs 90.2% alive at Day 30, respectively; P < 0.05), and compared with controls (N = 128) (81.2% vs 91.4% alive at Day 30, respectively; P < 0.05). Median length of hospital stay was 20 [interquartile range (IQR) 12-29] days for cases with hospital-onset NVE, and seven (IQR 2-13) days for controls (P < 0.001). In conclusion, community-onset NVE requiring hospitalization was associated with higher mortality compared with hospital-onset NVE and matched controls in hospitalized elderly patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Caliciviridae Infections / mortality*
  • Case-Control Studies
  • Community-Acquired Infections / mortality*
  • Enteritis / mortality*
  • Feces / virology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Norovirus / isolation & purification*
  • Retrospective Studies
  • Sweden / epidemiology
  • Time Factors
  • Young Adult