Laboratory Confirmation of Respiratory Syncytial Virus Infection Is Not Associated With an Increased Risk of Death in Adults With Acute Respiratory Illness - Scorecard - MDSpire

Laboratory Confirmation of Respiratory Syncytial Virus Infection Is Not Associated With an Increased Risk of Death in Adults With Acute Respiratory Illness

  • By

  • Jeffrey A Kline

  • Robert D Welch

  • Christopher Kabrhel

  • Daniel Mark Courtney

  • Carlos A Camargo

  • RESP-LENS site investigators

  • Michael J Roshon

  • Danielle E Turner-Lawrence

  • Michael A Puskarich

  • Ka Ming Gordon Ngai

  • Benton R Hunter

  • Joseph Bledsoe

  • James K d'Ettiene

  • Stephen S Lim

  • Christopher W Kabrhel

  • Esther J Choo

  • Steven M H Moore

  • Katherine R Buck

  • David M Beiser

  • James G Galbraith

  • Joby E Thoppil

  • Chris Kelly

  • Edward W Castillo

  • Israel E Green-Hopkins

  • Kristen S Nordenholz

  • Faheem C Guirgis

  • Bryan Wilson

  • Michael L Pulia

  • Stacey House

  • Justine M Pagenhardt

  • January 15, 2025

  • 0 min

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Clinical Scorecard: Confirmation of Respiratory Syncytial Virus Infection in Adults With Acute Respiratory Illness Does Not Correlate With Elevated Mortality Risk

At a Glance

CategoryDetail
ConditionRespiratory Syncytial Virus (RSV) infection in adults with acute respiratory illness (ARI)
Key MechanismsRSV causes symptomatic respiratory infections detected by PCR testing of nasopharyngeal swabs; infection associated with morbidity especially in older adults
Target PopulationAdults aged 18 years and older presenting with acute respiratory illness in emergency departments
Care SettingEmergency department setting across 91 US hospitals participating in RESP-LENS surveillance network

Key Highlights

  • Among 1,210,394 adults with ARI, 28.5% were tested for RSV; 2.4% tested positive.
  • RSV positivity was not associated with increased 30-day mortality or hospitalization after adjustment for confounders.
  • Age ≥65 years, worsening vital signs, male sex, and heart failure were independent predictors of mortality, not RSV status.

Guideline-Based Recommendations

Diagnosis

  • Use nasopharyngeal swab PCR testing for laboratory confirmation of RSV infection in adults presenting with ARI.

Management

  • Management decisions should consider patient age, vital signs, sex, and comorbidities rather than RSV positivity alone.
  • RSV positivity alone should not be used as a marker for increased risk of hospitalization or mortality.

Monitoring & Follow-up

  • Monitor vital signs and clinical status closely, especially in adults aged ≥65 years and those with heart failure.
  • Follow patients for 30 days post-ED visit to assess outcomes including hospitalization and mortality.

Risks

  • RSV infection in adults does not independently increase risk of hospitalization or 30-day mortality.
  • Older age, male sex, heart failure, and worsening vital signs are higher risk factors for adverse outcomes.

Patient & Prescribing Data

Adults with acute respiratory illness presenting to emergency departments and tested for RSV.

RSV positivity does not correlate with increased mortality risk; treatment and resource allocation should prioritize clinical risk factors over RSV test results.

Clinical Best Practices

  • Incorporate PCR-based RSV testing as part of usual care for adults with ARI in the ED to identify viral etiology.
  • Do not rely solely on RSV test positivity to predict hospitalization or mortality risk; assess comprehensive clinical factors.
  • Prioritize monitoring and management of older adults and those with comorbidities such as heart failure.
  • Use surveillance data to inform public health strategies but individual patient care should focus on clinical presentation.

References

Original Source(s)

Laboratory Confirmation of Respiratory Syncytial Virus Infection Is Not Associated With an Increased Risk of Death in Adults With Acute Respiratory Illness

  • by Jeffrey A Kline, Robert D Welch, Christopher Kabrhel, Daniel Mark Courtney, Carlos A Camargo, RESP-LENS site investigators, Michael J Roshon, Danielle E Turner-Lawrence, Michael A Puskarich, Ka Ming Gordon Ngai, Benton R Hunter, Joseph Bledsoe, James K d'Ettiene, Stephen S Lim, Christopher W Kabrhel, Esther J Choo, Steven M H Moore, Katherine R Buck, David M Beiser, James G Galbraith, Joby E Thoppil, Chris Kelly, Edward W Castillo, Israel E Green-Hopkins, Kristen S Nordenholz, Faheem C Guirgis, Bryan Wilson, Michael L Pulia, Stacey House, Justine M Pagenhardt

  • January 15, 2025

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