Affiliation:
1. Department of Medicine, Division of Hospital Medicine Northwestern University Feinberg School of Medicine Chicago Illinois USA
2. Department of Pediatrics, Division of Hospital‐Based Medicine Northwestern University Feinberg School of Medicine Chicago Illinois USA
3. Department of Pediatrics, Division of Pediatric Infectious Diseases Rush Medical College Chicago Illinois USA
4. Department of Medicine, Division of Infectious Diseases Rush Medical College Chicago Illinois USA
5. Department of Pediatrics, Division of Pediatric Infectious Diseases University of Rochester Medical Center Rochester New York USA
6. Department of Medicine, Division of Infectious Diseases University of California Irvine California USA
Abstract
AbstractBackgroundRespiratory syncytial virus (RSV), human metapneumovirus (hMPV), and parainfluenza virus (PIV) hospitalize many people yearly. Though severe lower respiratory tract disease has been described in children, the elderly, and the immunocompromised, there is a gap in our understanding of RSV, hMPV, and PIV in hospitalized adults. We sought to evaluate the association of RSV, hMPV, and PIV with severe respiratory disease requiring noninvasive or mechanical ventilation and death in hospitalized adults in the United States.MethodsWe conducted a retrospective, pooled, cross‐sectional study of general medicine hospitalizations in the United States from 2016 to 2019 using the National Inpatient Sample published by the Agency for Healthcare Quality and Research. We used multivariable Poisson regression to estimate the likelihood of severe respiratory disease or death. We used linear regression to estimate the mean difference in length of stay for those hospitalized with and without a respiratory virus.ResultsWe found that RSV (incidence rate ratio [IRR]: 1.68, 95% confidence interval [CI]: 1.61–1.74, p < .001), hMPV (IRR: 1.82, 95% CI: 1.71–1.93, p < .001), and PIV (IRR: 1.81, 95% CI: 1.68–1.94, p < .001) were independently associated with severe respiratory disease, even after adjustment. Additionally, we found the presence of a respiratory virus prolonged hospitalizations by (0.79 ± 0.27 days, p < .003) for RSV, (0.88 ± 0.28 days, p < .002) for hMPV, and (1.43 ± 0.30 days, p < .001) for PIV.ConclusionsRSV, hMPV, and PIV have a significant burden on hospitalized adults, even without classic risk factors.