Clinical characteristics and outcomes in adult patients hospitalized with influenza, respiratory syncytial virus and human metapneumovirus infections

ABSTRACT

Objectives: To compare the clinical characteristics and outcomes of patients hospitalized with respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and influenza infections.

Methods: This study prospectively enrolled 594 patients hospitalized with influenza-like illness (ILI) and laboratory-confirmed RSV, hMPV, or influenza infections over three consecutive influenza seasons at a tertiary hospital in China.

Results: While certain clinical features were of value as predictors of infection type, none exhibited good predictive performance as a means of discriminating between these three infections (area under the receiver-operating characteristic curve < 0.70). After controlling for potential confounding variables, RSV infections in pneumonia patients were found to be associated with a 30-day mortality risk comparable to that of influenza patients [odds ratio (OR) 1.016, 95% confidence interval (CI) 0.267–3.856, p = 0.982], whereas hMPV infection was associated with a reduced risk of mortality (OR 0.144, 95% CI 0.027–0.780, p = 0.025). Among those without pneumonia, the 30-day mortality risk in patients with influenza was comparable to that in patients infected with RSV (OR 1.268, 95% CI 0.172–9.355, p = 0.816) or hMPV (OR 1.128, 95% CI 0.122–10.419, p = 0.916).

Conclusion: Disease severity associated with these three types of viral infection was inconsistent when comparing patients with and without pneumonia, highlighting the importance of etiologic testing.

KEYWORDS:

• Influenza
• respiratory syncytial virus
• human metapneumovirus
• adult
• clinical characteristics
• disease severity

Acknowledgments

The authors would like to express their gratitude to EditSprings (https://www.editsprings.com/) for the expert linguistic services provided.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Supplemental material

Supplemental data for this article can be accessed here.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This study was funded by Beijing JST research (ZR-201921). The sponsor had no role in study design; the collection, analysis and interpretation of data; the writing of the report; and the decision to submit the article for publication.