Excess mortality following community-onset norovirus enteritis in the elderly

Area of Science:

• Infectious Diseases
• Epidemiology
• Geriatric Medicine

Background:

• Norovirus infection, specifically norovirus enteritis (NVE), is a significant public health concern.
• Previous studies suggest a potential association between norovirus and increased mortality rates.
• Understanding the specific mortality risks associated with NVE in different patient groups is crucial for public health interventions.

Purpose of the Study:

• To investigate the mortality rates and associated factors in hospitalized adult patients with norovirus enteritis (NVE).
• To compare mortality outcomes between community-onset NVE and hospital-onset NVE.
• To evaluate the impact of comorbidities and age on mortality following NVE.

Main Methods:

• A retrospective study was conducted on hospitalized adult patients with norovirus genogroup II infection confirmed by PCR.
• Cases (N=598) were compared with matched controls without enteritis (N=1196).
• Mortality up to 90 days, comorbidities, and length of hospital stay were analyzed. Survival rates were calculated at 30 and 90 days.

Main Results:

• Overall 30-day mortality was 7.6%, with no deaths in patients aged 18-59 years.
• Thirty-day mortality was higher in cases with underlying medical conditions and in elderly patients (>80 years) with community-onset NVE compared to hospital-onset NVE and controls.
• Hospital-onset NVE cases had a significantly longer median hospital stay (20 days) compared to controls (7 days).

Conclusions:

• Community-onset norovirus enteritis requiring hospitalization is associated with significantly higher mortality in elderly patients.
• Age and underlying comorbidities are critical factors influencing mortality risk in NVE patients.
• Distinguishing between community-onset and hospital-onset NVE is important for risk stratification and patient management.