Functional loss common in patients with RSV

For many older adults, functional decline, loss of independence, and ending up in a nursing home is something they dread more than death itself, said Professor Anne Fausley from the University of Rochester School of Medicine, Rochester, New York, US at ECCMID 2023.

“Maintaining independence is hugely important to an older person. In a hospital-based study I did with colleagues, respiratory syncytial virus (RSV) and hospitalization in elderly adults were associated with functional loss.” [Influenza and Other Respir Viruses 2022;16:1151-1160]

Median IADL* scores decreased significantly from pre-hospitalization to admission and remained low at discharge; 33 percent and 32 percent of patients had decreased IADL and activities of daily living (ADL) scores, respectively at 6 months.

“Forty percent of the cohort were independent when they came in. But 14 percent had a loss of independence at discharge. In multivariate analysis, male sex and diabetes were associated with a 6-month decline in ADL score of ≥10.”

“We’re also wondering about the effects on the brain, similar to what we might see with COVID. But we were not able to do a long-term assessment,” she continued. “Notably, even though half of these folks were independent at home living without any assistance, 28 percent had evidence of cognitive impairment at admission. This is a very dramatic illustration of their cognitive impairment.”

RSV infection is also being increasingly recognized as a cause of cardiovascular (CV) complications, Fausley shared. [J Am Coll Cardiol 2018;71:1574-1583]

“We’re just starting to understand this, but there seemed to be a relationship,” she added. In 69 adults hospitalized with RSV in Thailand, almost 25 percent had a CV complication (myocardial infarction, congestive heart failure, new atrial fibrillation). [J Clin Virol 2019;117:103-108]

Hospitalized RSV patients also experienced a significantly greater burden of lower respiratory tract symptoms, including cough, wheezing, and shortness of breath, during hospitalization and post-discharge. [Influenza and Other Respir Viruses 2022;16:79-89]

“The road back to health can be slow after RSV infection, with some older patients experiencing persistent shortness of breath and fatigue which may impact their quality of life,” concluded Fausley.