RSV Can Be As Severe as Unvaccinated COVID in Some Patients

(HealthDay News) — Disease severity is similar for patients hospitalized with respiratory syncytial disease (RSV) and unvaccinated adults with COVID-19 or influenza, according to a study published online April 4 in JAMA Network Open.

Diya Surie, M.D., from the U.S. Centers for Disease Control and Prevention in Atlanta, and colleagues examined disease severity among adults hospitalized with RSV and compared it to the severity of COVID-19 and influenza disease in a cohort study. A total of 7,998 adults admitted to the hospital with acute respiratory illness and laboratory-confirmed RSV, severe acute respiratory syndrome coronavirus 2, or influenza infection (6.1, 80.3, and 13.7 percent, respectively) were prospectively enrolled from 25 hospitals between Feb. 1, 2022, and May 31, 2023.

The researchers found that 12.0 percent of patients with RSV experienced invasive mechanical ventilation (IMV) or death compared with 14.2 and 9.2 percent, respectively, of unvaccinated and vaccinated patients with COVID-19 and 10.3 and 5.1 percent, respectively, of unvaccinated and vaccinated patients with influenza. The odds of IMV or in-hospital death were not significantly different for patients hospitalized with RSV and unvaccinated patients hospitalized with COVID-19 or influenza in adjusted analyses; the odds of IMV or death were significantly elevated among patients hospitalized with RSV versus vaccinated patients hospitalized with COVID-19 or influenza (adjusted odds ratios, 1.38 and 2.81, respectively).

“Newly approved RSV vaccines for adults aged 60 years and older have the potential to reduce this severity, similar to attenuation of disease severity achieved with COVID-19 and influenza vaccination, as previously reported and also observed in this analysis,” the authors write.

Several authors disclosed ties to the biopharmaceutical industry; one author disclosed a patent for an airway device.

What is RSV?

Respiratory syncytial virus (RSV) is a common viral infection that affects the respiratory tract. It can cause mild to severe symptoms, ranging from a common cold-like illness to more serious respiratory issues such as pneumonia or bronchiolitis. RSV is a significant cause of respiratory illness worldwide, with seasonal outbreaks occurring typically in the fall, winter, and early spring.

Infants and young children are particularly susceptible to RSV infection due to their immature immune systems. Premature infants, infants with congenital heart disease or chronic lung disease, and children with weakened immune systems are at higher risk of developing severe RSV-related complications. In older children and adults, RSV infections typically cause mild cold-like symptoms, but they can still transmit the virus to vulnerable populations.

Related: COVID Virus Found to Linger in Bodily Tissues for Over a Year

What are the symptoms of RSV?

Symptoms of RSV infection include a fever, runny nose, coughing, sneezing, and nasal congestion. These symptoms can progress to more severe respiratory symptoms such as wheezing, difficulty breathing, rapid breathing, and cyanosis (bluish discoloration of the skin due to lack of oxygen). In youth, RSV can lead to bronchiolitis, an inflammation of the small airways in the lungs, which can cause breathing difficulties and necessitate hospitalization.

Related: COVID-19 Vaccination in Pregnancy Shown to Be Safe for Infant Brain Development

How is RSV diagnosed?

Diagnosing RSV infection usually involves a combination of clinical symptoms, physical examination, and laboratory tests. Rapid antigen tests and polymerase chain reaction (PCR) assays can detect the presence of RSV in respiratory secretions, such as nasal swabs or throat swabs. Chest X-rays may also be used to evaluate the extent of lung involvement in severe cases.

Related: COVID-19 Vaccinations Bests Natural Immunity for Cutting Death, Hospitalizations

How to treat RSV

Treatment for RSV infection focuses on relieving symptoms and ensuring adequate hydration and oxygenation. In mild RSV cases, over-the-counter medications such as fever reducers and nasal decongestants may be recommended. However, antibiotics are not effective against viral infections like RSV and are only prescribed if there is a bacterial co-infection. In severe cases requiring hospitalization, supplemental oxygen therapy and mechanical ventilation may be necessary to support respiratory function.

Preventing RSV infection involves implementing various strategies to reduce transmission, especially in high-risk settings such as daycare centers and hospitals. These strategies include frequent handwashing, avoiding close contact with sick individuals, disinfecting surfaces regularly, and practicing proper respiratory hygiene, such as covering coughs and sneezes.

Vaccines for RSV are available for older adults and the CDC recommends maternal vaccination to prevent RSV in infants.

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