Abstract
Concomitant respiratory viral infections may influence clinical outcomes of acute decompensated heart failure (ADHF) but this association is based on indirect observation. The aim of this study was to evaluate the prevalence and impact of laboratory-confirmed influenza or respiratory syncytial virus (RSV) infection on outcomes in patients hospitalised for ADHF. Prospective cohort of patients hospitalised for ADHF with systematic influenza and RSV screening using real-time PCR on nasopharyngeal swabs. The primary outcome was all-cause mortality or readmission at 90 days. Among 803 patients with ADHF, 196 (24.5%) patients had concomitant flu-like symptoms of influenza. PCR was positive in 45 patients (27 for influenza, 19 for RSV). At 90 days, PCR positive patients had lower rates of all-cause mortality or readmission as compared to patients without flu-like symptoms (HR 0.40, 95% CI 0.18–0.91, p = 0.03), and non-significantly less all-cause mortality (HR 0.30, 95% CI 0.04–2.20, p = 0.24), or HF-related death or readmission (HR 0.36, 95% CI 0.13–0.99, p = 0.05). The prevalence of influenza or RSV infection in patients admitted for ADHF was low and associated with less all-cause mortality and readmission. Concomitant viral infection with ADHF may not in itself be a predictor of poor outcomes. (ClinicalTrials.gov NCT02444416).
Highlights
Acute decompensated heart failure (ADHF) is a leading cause of hospitalization and mortality in patients older than 65 years and prognosis remains poor [1,2,3]
polymerase chain reaction (PCR) was positive in 45 patients of which 27 were positive for influenza influenza (20 Influenza A and 7 Influenza B) and 19 were positive for respiratory syncytial virus (RSV); 1 patient was positive for both Influenza and RSV
In patients admitted for ADHF, the prevalence of concomitant PCR confirmed influenza or RSV infection was low, even in symptomatic patients during the influenza seasons
Summary
Acute decompensated heart failure (ADHF) is a leading cause of hospitalization and mortality in patients older than 65 years and prognosis remains poor [1,2,3]. Whilst influenza-like illness is a recognized syndrome, the association of laboratory confirmed influenza or RSV infection using polymerase chain reaction (PCR) with outcomes of patients hospitalised for ADHF has not previously been addressed [17].Influenza and RSV are the most common viral infections during seasonal epidemics and often have similar clinical presentations.
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