一个集群随机研究,探索病例定义,临床过程和社区居民50岁以上成年人RSV的后果
Alexander Domnich1, Francesco Lapi2, Andrea Orsi3,4,5
1Hygiene Unit, San Martino Polyclinic Hospital-IRCCS for Oncology and Neurosciences, Largo Rosanna Benzi 10, 16132, Genoa, Italy. alexander.domnich@hsanmartino.it.
Infectious diseases and therapy
|August 2, 2025
概括
使用急性呼吸道感染 (ARI) 病例定义的呼吸道同胞性病毒 (RSV) 监测捕获的老年人病例比流感类疾病 (ILI) 定义更多. RSV对老年人造成重大负担,影响临床和经济结果.
科学领域:
- 流行病学 流行病学
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
背景情况:
- 欧洲呼吸道同胞性病毒 (RSV) 监测被整合到现有的流感监测平台中,使用类似流感的疾病 (ILI) 或急性呼吸道感染 (ARI) 的病例定义.
- 本研究将ARI和ILI定义之间的RSV检测率进行比较,并研究RSV在老年人中的临床和经济影响.
研究的目的:
- 为了比较ARI与ILI病例定义在捕捉老年人RSV发病率方面的有效性.
- 描述RSV感染在这个人口群体中的临床过程和经济后果.
主要方法:
- 一项随机对照试验,在2023/2024和2024/2025赛季期间,涉及38名意大利全科医生.
- 招募50岁及以上的患有ARI或ILI的个人,并对呼吸道病原体进行检测,并对RSV阳性病例进行随访.
- 探索用于增强敏感性和特异性的替代案例定义.
主要成果:
- 在1431名患者中,RSV被检测到5.2%;ARI定义在5.8%的病例中检测到RSV,比ILI定义 (4.6%) 高出26%.
- 另一种包含特定症状的ARI定义显示92.0%的灵敏度和30.8%的特异性.
- 阳性RSV门诊患者的并发症率为30.7%,住院率为2.7%,病例死亡率为1.3%,社会成本显著.
结论:
- 与急性呼吸道感染 (ARI) 的定义相比,类似流感的疾病 (ILI) 监测可能低估了老年人中的RSV发病率.
- 通过使用额外的合格符来改进ARI案例定义,可以提高具体性.
- 呼吸道同胞性病毒 (RSV) 对老年人群构成重大临床和经济负担.
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