Clinical and Epidemiologic Characteristics of Hospitalized Patients With Laboratory-Confirmed Respiratory Syncytial Virus Infection in Eastern China Between 2009 and 2013: A Retrospective Study

PLoS One. 2016 Nov 1;11(11):e0165437. doi: 10.1371/journal.pone.0165437. eCollection 2016.

Abstract

Respiratory syncytial virus (RSV) is a leading cause of morbidity and mortality worldwide in children aged <5 years and older adults with acute lower respiratory infections (ALRIs). However, few studies regarding the epidemiology of hospitalizations for RSV infection have been performed previously in China. Here, we aimed to describe the clinical and epidemiologic characteristics of hospitalized patients with laboratory-confirmed RSV infection in eastern China. Active surveillance for hospitalized ALRI patients using a broad case definition based on symptoms was performed from 2009-2013 in 12 sentinel hospitals in eastern China. Clinical and epidemiologic data pertaining to hospitalized patients of all ages with laboratory-confirmed RSV infection by PCR assay were collected and analyzed in this study. From 2009 to 2013, 1046 hospitalized patients with laboratory-confirmed RSV infection were enrolled in this study, and 14.7% of patients had subtype A, 24.2% of patients had subtype B, 23.8% of patients with subtype not performed, and 37.3% of patients had RSV coinfections with other viruses. RSV and influenza coinfections (33.3%) were the most common coinfections noted in this study. Moreover, young children aged <5 years (89.1%, 932/1046), particularly young infants aged <1 year (43.3%, 453/1046), represented the highest proportion of patients with RSV infections. In contrast, older adults aged ≥60 years (1.1%, 12/1046) represented the lowest proportion of patients with RSV infections among enrolled patients. The peak RSV infection period occurred mainly during autumn and winter, and 57% and 66% of patients exhibited symptoms such as fever (body temperature ≥38°C) and cough separately. Additionally, only a small number of patients were treated with broad-spectrum antiviral drugs, and most of patients were treated with antimicrobial drugs that were not appropriate for RSV infection. RSV is a leading viral pathogen and a common cause of viral infection in young children aged <5 years with ALRIs in eastern China. Effective vaccines and antiviral agents targeting RSV are needed to mitigate its large public health impact.

MeSH terms

  • Adolescent
  • Adult
  • Antiviral Agents / therapeutic use
  • Child
  • Child, Preschool
  • China / epidemiology
  • Coinfection / diagnosis
  • Coinfection / drug therapy
  • Coinfection / epidemiology
  • Coinfection / virology
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Infant, Newborn
  • Influenza A virus / drug effects
  • Influenza A virus / isolation & purification
  • Influenza, Human / diagnosis
  • Influenza, Human / drug therapy
  • Influenza, Human / epidemiology
  • Influenza, Human / virology
  • Male
  • Middle Aged
  • Respiratory Syncytial Virus Infections / diagnosis*
  • Respiratory Syncytial Virus Infections / drug therapy
  • Respiratory Syncytial Virus Infections / epidemiology*
  • Respiratory Syncytial Virus Infections / virology
  • Respiratory Syncytial Virus, Human / drug effects
  • Respiratory Syncytial Virus, Human / isolation & purification*
  • Respiratory Tract Infections / diagnosis
  • Respiratory Tract Infections / drug therapy
  • Respiratory Tract Infections / epidemiology
  • Retrospective Studies
  • Young Adult

Substances

  • Antiviral Agents

Grant support

This study was supported by grants from the National Science Fund for Distinguished Young Scholars (81525023), and the Ministry of Science and Technology of the People’s Republic of China (the National Key Science and Technology Project on Infectious Disease Surveillance Technique Platform of China, 2012ZX10004-201, 2012ZX10004-210).