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Respiratory syncytial virus and influenza virus infection in adult primary care patients: association of age with prevalence, diagnostic features and illness course

Respiratory syncytial virus and influenza virus infection in adult primary care patients: association of age with prevalence, diagnostic features and illness course
Respiratory syncytial virus and influenza virus infection in adult primary care patients: association of age with prevalence, diagnostic features and illness course

Objectives: To better target new vaccines and treatments being developed for respiratory syncytial virus (RSV) and influenza virus (influenza), we studied the association of age with prevalence, diagnostic features and course of illness of these infections in primary care patients. Methods: Secondary analysis of observational data on the aetiology, diagnosis and prognosis in adults presenting to primary care with acute cough in 12 European countries (2007–2010) using regression analyses corrected for clustering of patients within countries. Age groups were 18–59 years, 60–74 years, and 75 years and older (75+). Results: Nasopharyngeal swabs for 144 (4.6%), 169 (5.4%) and 104 (3.4%) out of 3104 patients were polymerase chain reaction (PCR) positive for RSV, influenza A and influenza B, respectively. RSV prevalence in patients 75+ (8.5%) was twice the prevalence in those under 60 years (4.2%). Influenza prevalence was not associated with age. Diagnostic features for these viruses were not associated with age. Symptom duration was associated with age for RSV and influenza B, but not for influenza A. The odds of unresolved symptoms after 28 days were associated with age for RSV only. Illness deterioration was associated with age for RSV, with patients 75+ at increased risk, but not for influenza. Conclusion: In adults presenting to primary care with acute cough, the diagnostic features of RSV or influenza infection are not associated with age. For RSV both the prevalence and illness course are significantly worse at higher age, for influenza only the illness course is.

Acute cough, Influenza virus, Primary care, Respiratory syncytial virus
1201-9712
384-390
Bruyndonckx, Robin
f4de37c8-5255-4d22-936b-62a7c900c81a
Coenen, Samuel
83e83064-aeea-4ded-9a3f-d0b2329a2f7b
Butler, Chris C.
cedab343-9e0c-420f-ba80-f2f824969687
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
GRACE Project Group
Bruyndonckx, Robin
f4de37c8-5255-4d22-936b-62a7c900c81a
Coenen, Samuel
83e83064-aeea-4ded-9a3f-d0b2329a2f7b
Butler, Chris C.
cedab343-9e0c-420f-ba80-f2f824969687
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777

Bruyndonckx, Robin, Coenen, Samuel and Butler, Chris C. , GRACE Project Group (2020) Respiratory syncytial virus and influenza virus infection in adult primary care patients: association of age with prevalence, diagnostic features and illness course. International Journal of Infectious Diseases, 95, 384-390. (doi:10.1016/j.ijid.2020.04.020).

Record type: Article

Abstract

Objectives: To better target new vaccines and treatments being developed for respiratory syncytial virus (RSV) and influenza virus (influenza), we studied the association of age with prevalence, diagnostic features and course of illness of these infections in primary care patients. Methods: Secondary analysis of observational data on the aetiology, diagnosis and prognosis in adults presenting to primary care with acute cough in 12 European countries (2007–2010) using regression analyses corrected for clustering of patients within countries. Age groups were 18–59 years, 60–74 years, and 75 years and older (75+). Results: Nasopharyngeal swabs for 144 (4.6%), 169 (5.4%) and 104 (3.4%) out of 3104 patients were polymerase chain reaction (PCR) positive for RSV, influenza A and influenza B, respectively. RSV prevalence in patients 75+ (8.5%) was twice the prevalence in those under 60 years (4.2%). Influenza prevalence was not associated with age. Diagnostic features for these viruses were not associated with age. Symptom duration was associated with age for RSV and influenza B, but not for influenza A. The odds of unresolved symptoms after 28 days were associated with age for RSV only. Illness deterioration was associated with age for RSV, with patients 75+ at increased risk, but not for influenza. Conclusion: In adults presenting to primary care with acute cough, the diagnostic features of RSV or influenza infection are not associated with age. For RSV both the prevalence and illness course are significantly worse at higher age, for influenza only the illness course is.

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Accepted/In Press date: 7 April 2020
e-pub ahead of print date: 19 April 2020
Published date: June 2020
Additional Information: Funding Information: RB is funded as a postdoctoral researcher by the Research Foundation – Flanders (FWO). SC, CB, NH, PB and HG are members of the Respiratory Syncytial Virus Consortium in Europe (RESCUE). RESCUE has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement no. 116019. NH acknowledges support from the University of Antwerp scientific chair in Evidence-Based Vaccinology, financed in 2009−2020 by a gift from Pfizer and in 2016–2019 from GSK . Funding Information: The GRACE project was funded by the European Community's Sixth Framework Programme (grant agreement 518226 ). Work in the UK was also supported by the National Institute for Health Research . Work in Barcelona was also supported by 2009 SGR 911 Ciber de Enfermedades Respiratorias (Ciberes CB06/06/0028). Work in Belgium was also supported by the Methusalem financing programme of the Flemish Government and by FWO ( G.0274.08N ). This work was also supported through the European Science Foundation ( ESF ), in the framework of the Research Networking Programme TRACE ( www.esf.org/trace ). Publisher Copyright: © 2020 The Author(s)
Keywords: Acute cough, Influenza virus, Primary care, Respiratory syncytial virus

Identifiers

Local EPrints ID: 439336
URI: http://eprints.soton.ac.uk/id/eprint/439336
ISSN: 1201-9712
PURE UUID: 8532496a-f2ac-4131-befa-4e359d2f0b21

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Date deposited: 16 Apr 2020 16:37
Last modified: 23 Sep 2022 04:01

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Contributors

Author: Robin Bruyndonckx
Author: Samuel Coenen
Author: Chris C. Butler
Author: Paul Little
Corporate Author: GRACE Project Group

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