title: Clinical characteristics and outcome of respiratory syncytial virus infection among adults hospitalized with influenza-like illness in France.
abstract: OBJECTIVE
  The aim of this study was to analyse characteristics and outcome of respiratory syncytial virus (RSV) infection in adults hospitalized with influenza-like illness (ILI).
  
  
  METHODS
  Patients hospitalized with ILI were included in this prospective, multicentre study carried out in six French hospitals during three consecutive influenza seasons (2012-2015). RSV and other respiratory viruses were detected by multiplex PCR in nasopharyngeal swabs. Risk factors for RSV infection were identified by backward stepwise logistic regression analysis.
  
  
  RESULTS
  A total of 1452 patients hospitalized with ILI were included, of whom 59% (861/1452) were >65 years and 83% (1211/1452) had underlying chronic illnesses. RSV was detected in 4% (59/1452), and influenza virus in 39% (566/1452). Risk factors for RSV infection were cancer (adjusted OR 2.1, 95% CI 1.1-4.1, p 0.04), and immunosuppressive treatment (adjusted OR 2.0, 95% CI 1.1-3.8, p 0.03). Patients with RSV had a median length of stay of 9 days (6-25), and 57% of them (30/53) had complications, including pneumonia (23/53, 44%) and respiratory failure (15/53, 28%). Fifteen per cent (8/53) were admitted to an intensive care unit, and the in-hospital mortality rate was 8% (4/53). Pneumonia was more likely to occur in patients with RSV than in patients with RSV-negative ILI (44% (23/53) versus 26% (362/1393), p 0.006) or with influenza virus infection (44% versus 28% (157/560), p 0.02).
  
  
  CONCLUSIONS
  RSV is an infrequent cause of ILI during periods of influenza virus circulation but can cause severe complications in hospitalized adults. Risk factors for RSV detection in adults hospitalized with ILI include cancer and immunosuppressive treatment. Specific immunization and antiviral therapy might benefit patients at risk.
authors.affiliation: IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, France; Service de Maladies Infectieuses et Tropicales, Hôpital Bichat, AP-HP, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Loubet
authors.affiliation: Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Lenzi
authors.affiliation: CNR Virus Influenza, Institut des Agents Infectieux, GHN, Hospices Civils de Lyon, Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Valette
authors.affiliation: CHU de Montpellier, Laboratoire de Virologie, Hôpital Saint Eloi, Inserm U 1058, Montpellier, France.
authors.forename: V
authors.initials: V
authors.lastname: Foulongne
authors.affiliation: AP-HP, Hôpital Cochin Broca Hôtel-Dieu, Laboratoire de Virologie, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Krivine
authors.affiliation: AP-HP, Hôpital Bichat-Claude Bernard, Laboratoire de Virologie, Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Houhou
authors.affiliation: CHRU Pontchaillou, Laboratoire de Virologie, Rennes, France.
authors.forename: G
authors.initials: G
authors.lastname: Lagathu
authors.affiliation: CHU Dupuytren, Service Bactériologie, Virologie, Hygiène, Limoges Cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Rogez
authors.affiliation: CHU Dupuytren, Laboratoire de Virologie, Limoge Cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Alain
authors.affiliation: IAME, UMR 1137, INSERM, Université Paris Diderot, Sorbonne Paris Cité, France; Inserm CIC 1425, Hôpital Bichat-Claude Bernard, APHP, Paris, France.
authors.forename: X
authors.initials: X
authors.lastname: Duval
authors.affiliation: Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France; CHU de Montpellier, Inserm CIC 1411, Hôpital Saint-Eloi, Montpellier, France.
authors.forename: F
authors.initials: F
authors.lastname: Galtier
authors.affiliation: CHU Dupuytren, CIC 1435, Limoge Cedex, France.
authors.forename: D
authors.initials: D
authors.lastname: Postil
authors.affiliation: CHRU Pontchaillou, Maladies Infectieuses et Réanimation Médicale, CIC INSERM 1414, Rennes, France.
authors.forename: P
authors.initials: P
authors.lastname: Tattevin
authors.affiliation: Service d'Hygiène, Epidémiologie et Prévention, Groupement Hospitalier Edouard Herriot, Lyon, France; Emerging Pathogens Laboratory - Fondation Mérieux, Centre International de Recherche en Infectiologie (CIRI) Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, Lyon, France.
authors.forename: P
authors.initials: P
authors.lastname: Vanhems
authors.affiliation: Sorbonne Universités, UPMC Univ Paris 06, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France; Public health department, Hopital Saint-Antoine, APHP, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Carrat
authors.affiliation: CNR Virus Influenza, Institut des Agents Infectieux, GHN, Hospices Civils de Lyon, Lyon, France; CIRI, Centre International de Recherche en Infectiologie, Virpath, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, École Normale Supérieure de Lyon, Hospices Civils de Lyon, Univ Lyon, Lyon, France.
authors.forename: B
authors.initials: B
authors.lastname: Lina
authors.affiliation: Inserm, F-CRIN, Innovative clinical research network in vaccinology (I-REIVAC), Paris, France; Inserm, CIC 1417, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Paris, France; Department of Infectious Diseases, CIC Cochin Pasteur, Cochin Broca Hôtel-Dieu hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France. Electronic address: odile.launay@aphp.fr.
authors.forename: O
authors.initials: O
authors.lastname: Launay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003937:Diagnosis, Differential; D005260:Female; D005602:France / Q000453:epidemiology; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007251:Influenza, Human / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D063868:Patient Outcome Assessment; D018357:Respiratory Syncytial Virus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D018113:Respiratory Syncytial Virus, Human; D012307:Risk Factors; D012621:Seasons; D055815:Young Adult
keywords: Adults; Elderly; Influenza; Influenza-like illness; Pneumonia; Respiratory syncytial virus