Virus Infection In Adults Research Articles

Implementation of a rapid host-protein diagnostic test for distinguishing bacterial and viral infections in adults presenting to urgent care centers: a pragmatic cohort study

BackgroundUrgent care centers (UCCs) are a growing segment of healthcare with high rates of inappropriate antibiotic use. MeMed BV® (MMBV) is a blood test that differentiates bacterial from viral infections. Between April 2022 and March 2023, we introduced MMBV into routine care at ten UCCs. The primary objective was to assess MMBV’s impact on antibiotic use; the secondary objective was to assess whether MMBV aided in patient management.MethodsA pragmatic prospective cohort study. Physicians who ordered MMBV reported electronically (in real-time) whether they intended to prescribe antibiotics before ordering the test and upon UCC discharge whether MMBV aided in patient management. Hospitalizations were recorded for 7 days post-UCC discharge.ResultsDuring implementation, 3920 MMBV tests were ordered for adults (age ≥ 18) by 144 physicians. The study cohort had 59% female patients and the median age was 42 years (IQR 31–58). For the primary objective, 3262 cases were included. MMBV indicated 629/3262 (19.3%) cases of potentially unwarranted antibiotics, of which physicians avoided prescriptions in 397/629 (63.1%). MMBV indicated 405/3262 (12.4%) cases of potentially missed bacterial infections. Physicians prescribed antibiotics to 283/405 (69.9%). MMBV adherence was associated with fewer hospitalizations (7.8% vs. 30.3%, p < 0.001). For the secondary objective, 2901 cases were included. Physicians reported MMBV aided patient management in 2494/2901 (86.0%) cases and contributed to avoiding emergency department referrals in 595/2901 (20.5%).ConclusionsImplementing MMBV aided urgent care center physicians in their clinical decision-making and may have contributed to appropriate antibiotic use, better resource utilization, and patient management.

Respiratory syncytial virus infections in adults.

Respiratory syncytial virus (RSV) infections as an important cause of acute respiratory illness (ARI) and exacerbation of chronic lung disease in adults especially affect older adults, adults with immunosuppression, and adults with chronic disease, particularly pulmonary or cardiac disease, who may develop more severe complications. A more accurate determination of the burden of RSV infection in the adult population would improve the approach to infection, especially considering the growth of the older adult population in the world and, above all, that there are currently three approved vaccines aimed at the adult population that could have an effect on the prevention of RSV infection. This review article reviews the most relevant and novel scientific evidence on the epidemiology, diagnosis, treatment and prevention of RSV infection in the adult population.

Burden and Economic Impact of Respiratory Viral Infections in Adults Aged 60 and Older: A Focus on RSV

Background/Objectives: Respiratory syncytial virus (RSV) represents a significant cause of acute respiratory infections (ARIs) in adults aged 60 years and older, often leading to severe clinical outcomes and high healthcare costs. This study aimed to evaluate the clinical and economic burden of RSV compared to other ARIs, focusing on specific age groups, comorbidities, and demographic factors. Methods: A retrospective observational study was conducted using the electronic medical records of adults aged ≥60 years hospitalized for ARIs, including RSV, in Spain. Direct costs related to hospitalizations, intensive care unit (ICU) admissions, and treatments were analyzed. The study also assessed demographic, clinical, and comorbidity-related factors influencing the economic burden. Results: RSV infections resulted in significantly higher direct costs compared to other ARIs, particularly in patients aged 70–80 years. Comorbidities such as asthma and smoking history were associated with increased costs in RSV cases. Although ICU costs were comparable between groups, hospitalizations for RSV required longer stays and more intensive treatments, amplifying the overall economic burden. Differences in costs by age and sex highlighted the need for tailored clinical management strategies. Conclusions: RSV poses a substantial economic and clinical burden on adults aged 60 years and older, particularly in those with comorbidities. Preventive measures, such as vaccination, could reduce healthcare costs and improve outcomes in this vulnerable population. These findings support the inclusion of RSV vaccines in immunization programs, especially in aging populations like Spain, to alleviate healthcare pressures during peak respiratory disease seasons.

Issues of treatment and prevention of recurrent inflammatory diseases of the upper respiratory tract: An immunologist's view. A review

Often ill people are, first of all, patients with recurrent infectious and inflammatory diseases of the upper respiratory tract (URT). They put a significant financial burden on the healthcare system. The leading etiological factors of recurrent inflammatory diseases of URT, in addition to pathogenic bacterial microflora, are viral agents (viruses of the viral respiratory infections group, herpes viruses). The chronic infection and recurrence of local inflammation is due to the persistence of resident bacterial and viral flora (including herpes viruses), and as a result, the insufficiency of the mucosal immune response. In order to optimize therapeutic and preventive measures for frequently ill adults and children, the most promising is the use of immunotherapy and immunoprophylaxis. The immunomodulator inosine pranobex, due to its unique combined (immunotropic and antiviral) properties, demonstrates effectiveness in the complex treatment of viral respiratory infections, including in combination with herpes viruses, and is successfully used to prevent frequent relapses of infectious and inflammatory diseases of the URT. The domestic analogue of inosine pranobex Normomed® [JSC "Valenta Pharm"», ЛП-№(002470)-(РГ-RU), ЛП-№(005542)-(РГ-RU)], has a good safety and bioequivalence profile, and occupies a worthy field in the Russian pharmaceutical market among drugs recommended for the treatment of viral infections in adults and children.

Comparison of two rapid host-response tests for distinguishing bacterial and viral infection in adults with acute respiratory infection

Distinguishing bacterial from viral acute respiratory infection (ARI) is challenging, leading to inappropriate antimicrobial use and antimicrobial resistance. We evaluated the accuracy of two host-response tests to differentiate bacterial and viral infection. This study used patient blood samples previously collected during a randomised controlled trial of adults hospitalised with ARI. The aetiology for each patient was clinically adjudicated. PAXgene blood RNA samples were tested using the TriVerity test (which measures 29 mRNAs) and serum samples were tested using the MeMed BV test (which measures 3 proteins). Diagnostic accuracy was calculated against adjudicated aetiology. 169 patients were tested. Median age was 60 (45-74) years and 152 (90%) received antibiotics. 60 (36%) were adjudicated as bacterial, 54 (32%) as viral, 26 (15%) as viral/bacterial co-infection, and 29 (17%) as non-infected. For bacterial (including bacterial/viral co-infection) versus non-bacterial infection, the TriVerity bacterial score had a Positive Percentage Agreement (PPA) of 81% (95%CI 70-89) and a Negative Percentage Agreement (NPA) of 66% (95%CI 55-79) and the MeMed BV score had a PPA of 96% (95%CI 90-99) and NPA of 34% (95%CI 23-47). The AUROC for the two tests was 0.77 (95%CI 0.70-0.84) and 0.81 (95%CI 0.74-0.87) respectively, p=0.388. Both tests demonstrated similar overall accuracy for distinguishing bacterial infection with the Triverity test missing some bacterial infections and MeMed BV misclassifying most viral infections as bacterial. Prospective impact studies evaluating antibiotic use, safety and cost effectiveness are now required.

Secondary healthcare resource utilization and related costs associated with influenza-related hospital admissions in adult patients, England 2016 – 2020

ABSTRACT Introduction This study aims to investigate healthcare resource utilization and related costs for influenza virus infections in adults admitted into secondary care in England across four influenza seasons. Methods This study includes all influenza admissions from the Hospital Episode Statistics database (HES) across England, September 2016 to March 2020. Descriptive analyses and comparative modeling techniques were used to assess the impact of influenza on risk groups of interest. Results Influenza admissions were estimated to cost £401 M. Average admission costs were heavily impacted by age and comorbid status, with comorbid patients representing 91% of costs. Additionally, patients with comorbidities treated in secondary care cost twice as much as non-comorbid patients, after adjusting for age and gender. Comorbid patients also had increased length of stay (LOS) and admissions to ICU, with patients’ LOS being a core contributing factor to higher costs. Conclusion The study documents the substantial burden of influenza in England, emphasizing the impact of age and comorbid status on healthcare resource utilization (HCRU) and related costs. The data presented offers critical information to healthcare systems evaluating new strategies to alleviate the winter pressures on the NHS; highlighting the need to implement vaccination campaigns with enhanced vaccinations and increased vaccine coverage.

Observational Study on the Clinical Reality of Community-Acquired Respiratory Virus Infections in Adults and Older Individuals.

The impact of common respiratory virus infections on adults and older individuals in the community is unclear, excluding seasonal influenza viruses. We examined FilmArray® tests performed on 1828 children aged <10 years and 10,803 adults, including cases with few respiratory symptoms, between January 2021 and June 2024. Approximately 80% of the children tested positive for ≥1 viruses, while 9.5% of the adults tested positive mostly for severe acute respiratory syndrome corona virus-2 (SARS-CoV-2). Besides SARS-CoV-2 infection, 66 out of 97 patients (68.0%) aged >60 years with rhinovirus/enterovirus (RV/EV), respiratory syncytial virus (RSV), parainfluenza virus-3 (PIV-3), or human metapneumovirus (hMPV) infection required hospitalization, of whom seven died; 26 out of 160 patients (16.3%) aged <60 years required hospitalization mostly because of deterioration of bronchial asthma, with no reported deaths. In older patients with RV/EV infection, three with few respiratory symptoms died due to worsened heart failure. Although the frequency of common respiratory virus infections in older adults is low, it may be overlooked because of subclinical respiratory symptoms, and its clinical significance in worsening comorbidities in older adults should not be underestimated.

Immune modulation by dexketoprofen trometamol, a selective eicosanoid biosynthesis inhibitor of cellular immune response and phenoloxidase reaction in response to viral infection in Pimpla turionellae adults

Immune modulation by dexketoprofen trometamol, a selective eicosanoid biosynthesis inhibitor of cellular immune response and phenoloxidase reaction in response to viral infection in Pimpla turionellae adults

Effectiveness of vitamin c in the management of viral infections in adults

Effectiveness of vitamin c in the management of viral infections in adults

Expert recommendations on screening, testing and management for hepatitis B virus infection in adults

The prevalence of hepatitis B represents a significant public health concern with a heavy disease burden. In China, there is still a big gap between the current diagnosis and treatment rates of hepatitis B and the goal of eliminating viral hepatitis as a public health threat by 2030 set by the World Health Organization (WHO). In order to achieve the WHO goal and the goal of 2030 Healthy China Outline, the Chinese Preventive Medicine Association organized domestic experts in the fields of clinical medicine, public health and clinical laboratory medicine to develop the Expert Recommendations on Screening, Testing and Management for Hepatitis B Virus Infection in Adults after several rounds of discussion based on comprehensive review of relevant domestic and international guidelines and literatures, the purpose is to facilitate universal screening of hepatitis B virus(HBV)infection in adults and provide practical guidance on disease assessment, treatment and long-term follow-up management of people infected with HBV and vaccination for people susceptible to HBV infection,thus promoting the elimination of the threat of hepatitis B.

Epidemiological study of respiratory syncytial virus infection in adults during the pandemic of COVID-19

While respiratory syncytial virus (RSV) is one of the most common pathogens in adults admitted to the ICU due to respiratory diseases, no reports regarding the occurrence rate of RSV infections in adults in Japan during the COVID-19 pandemic exist. We conducted this retrospective study to examine the exact occurrence rate of RSV infections in adults. We reviewed all patients (≥18 years) with any respiratory symptoms who received quantitative polymerase chain reaction (PCR) using nasopharyngeal samples for respiratory viruses by GeneLEAD at the Aichi Medical University Hospital between November 2022 and November 2023. A total of 541 adult patients who underwent PCR test were enrolled in this study. RSV was identified in 18 cases (3.3%); 8 (1.5%) upper and 10 (1.8%) lower respiratory tract infections. Influenza A and SARS-CoV-2 were found in 10 (1.8%) and 61 (11.3%), respectively. Patients with RSV infections and COVID-19 had more comorbidities than those with Influenza virus infections. As for RSV-associated with lower respiratory tract infection cases, 10 developed acute respiratory failure, resulting in 1 fatal case due to pneumonia and 1 died of septic shock due to ileus. The 30-, 90-day mortality rates were 1 (6%) and 2 (11%) respectively. About 3% of adults had RSV infections during the COVID-19 pandemic. The outcomes of RSV infections in adults were similar to those by COVID-19. Those with comorbidities should have a preventive method against RSV infections, the same as for COVID-19.

Asymptomatic Enteric Virus Infections and Association with the Gut Microbiome in Rural Residents of Northern Laos.

Viral gastrointestinal infections are an important public health concern, and the occurrence of asymptomatic enteric virus infections makes it difficult to prevent and control their spread. This study aimed to determine the prevalence of and factors associated with asymptomatic enteric virus infection in adults in northern Laos. Fecal samples were collected from apparently healthy participants who did not report diarrhea or high fever at the time of the survey in northern Laos, and enteric viruses were detected using polymerase chain reaction (PCR) and reverse transcription (RT)-PCR. Individual characteristics, including the gut microbiome, were compared between asymptomatic carriers and noncarriers of each enteric virus. Of the participants (N = 255), 12 (4.7%) were positive for norovirus genogroup I (GI), 8 (3.1%) for human adenovirus, and 1 (0.4%) for norovirus GII; prevalence tended to be higher in less-modernized villages. Gut microbial diversity (evaluated by the number of operational taxonomic units) was higher in asymptomatic carriers of norovirus GI or human adenovirus than in their noncarriers. Gut microbiome compositions differed significantly between asymptomatic carriers and noncarriers of norovirus GI or human adenovirus (permutational analysis of variance, P <0.05). These findings imply an association between asymptomatic enteric virus infection and modernization and/or the gut microbiome in northern Laos.

Epidemiology and Disease Burden of Respiratory Syncytial Virus Infection in Adults.

Respiratory syncytial virus (RSV) constitutes a significant cause of respiratory illness and mortality among older adults, a demographic that is expanding with considerable impact on healthcare systems worldwide. The actual burden of RSV in this population may still be underestimated, owing to factors such as low awareness and suboptimal diagnostic sensitivity in adults, the lack of robust RSV surveillance systems, and the infrequent use of diagnostic testing. Recent advancements in respiratory virus detection have spurred further exploration into appropriate preventive and therapeutic strategies. The recent approval of two vaccines highlights the critical need for the precise estimation of the RSV disease burden to optimize the effectiveness and cost-efficiency of immunization programs. This narrative review aimed to summarize the existing knowledge of the RSV burden in adults with a particular focus on older adults, incorporating data from Korea. Overall, current estimates indicate that the annual RSV attack rate in the general adult population ranges from 1 - 7%, increasing to approximately 4 - 10% among elderly and high-risk groups. The in-hospital mortality rate can be estimated to be around 7 - 10%, rising up to 40% among intensive care unit-admitted patients. To elucidate RSV's disease burden, further continuing research, including population-based studies, is necessary.

Clinical efficiency and safety of riamilovir under various dosage regimens for treatment of acute respiratory viral infections in adults

To evaluate the clinical efficacy and safety of antiviral drug riamilovir in patients with acute respiratory viral infections (ARVI) of non-coronavirus (SARS-CoV-2) etiology with different dosing regimens. The study included 150 patients with ARVI aged 18-27 years (50 patients received riamilovir in the regimen of 250 mg 3 times a day for 5 days, 50 patients received riamilovir in the off label regimen of 250 mg 5 times a day for 5 days, 50 patients received only pathogenetic treatment). The use of riamilovir in both treatment regimens led to a reduction in the duration of inpatient treatment. The shortest periods of hospitalization were noted in patients who received the study drug at higher daily dosages. The use of riamilovir reduced the duration and severity of general infectious manifestations of the disease, while the shortest total duration of fever and a number of respiratory tract syndromes was registered among people who received riamilovir in the regimen of 1250 mg per day for 5 days, no adverse events were registered, additionally, 100% elimination of ARVI pathogens was noted in 1250 mg per day group. Riamilovir has shown clinical efficacy and a good safety profile in in both treatment regimens. The dosage regimen of 1250 mg per day led to more significant clinical effects and to 100% elimination of ARVI pathogens in the study group by the 6th day of hospitalization.

Retrospective analysis of respiratory virus infections in adults with hematologic malignancies.

The study aimed to evaluate respiratory virus infections in adult patients with hematological malignancies (HM). The medical records of patients who were followed up by the hematology clinic at Başakşehir Çam and Sakura City Hospital between March 2021 and March 2023 with a diagnosis of HM and who underwent real-time polymerase chain reaction (RT-PCR) testing for nasopharyngeal/oropharyngeal specimens taken with suspected respiratory tract infection constituted the study data. Infections were symptomatic in 64.56% of patients, and the most common symptoms were fever (48.10%) and cough (18.99%). The mortality rate was 25.32% over a two-year period. When the samples were examined, positive test frequency was 43.04%, and the three most common pathogens were Influenza A (10.13%), SARS-CoV-2 (8.86%), and rhinovirus/enterovirus (7.59%). The frequency of positive tests from HMs was highest in patients with AML (p=0.042). Respiratory PCR kit positivity was higher in patients who had any symptoms (p=0.002) and cough (p=0.003). Test positivity was higher in patients with any pathological radiological finding (p=0.039) and ground glass appearance (p=0.010). The risk of death was found to be 5.848 times higher in patients with dyspnea compared to those without (OR: 5.848, 95% CI: 1.143-29.915, p=0.034). Respiratory tract virus panel PCR test positivity is more common in patients with HM presenting with respiratory tract infection symptoms in the presence of AML diagnosis, symptomatic infection, cough, radiological findings, and ground glass appearance. Mortality risk is high in HM patients with respiratory tract virus infection who have shortness of breath.

Global prevalence of respiratory virus infections in adults and adolescents during the COVID-19 pandemic: A systematic review and meta-analysis

Since the beginning of the COVID-19 pandemic, efforts have been made to contain the spread of the virus. However, the epidemiological burden of other respiratory viruses during the pandemic is unclear. We aim to address the epidemiology of respiratory viruses on adults/adolescents since the beginning of the pandemic. We systematically searched five databases and performed a meta-analysis to explore the pooled prevalence of respiratory viruses in different geographical regions, age groups, and periods and compared the prevalence between COVID-19 cases and non-COVID-19 patients. Enteroviruses/rhinoviruses were highly prevalent compared to other viruses. Different viruses were dominant in different regions. No significant differences in prevalence were found between different age groups, except for human metapneumovirus. There was an increase in prevalence of non-SARS-CoV-2 viruses in the second half of the pandemic (July 2021-December 2022). Comparison of COVID-19 and non-COVID patients showed a higher prevalence in the non-COVID group, significant for influenza, seasonal coronaviruses, and human parainfluenza viruses. Our findings indicate that enteroviruses/rhinoviruses were less impacted by healthcare measures compared with other respiratory viruses. The relaxation of measures in the second half led to an increased pooled prevalence of infections. Several factors may explain the lower prevalence among individuals infected with COVID-19.

Clinical Characterization of Respiratory Syncytial Virus Infection in Adults: A Neglected Disease?

Lower respiratory tract infections (LRIs) are a significant cause of disability-adjusted life-years (DALYs) across all age groups, especially in children under 9 years of age, and adults over 75. The main causative agents are viruses, such as influenza and respiratory syncytial virus (RSV). Viral LRIs in adults have historically received less attention. This study investigated the incidence of RSV and influenza in adult patients admitted to a referral hospital, as well as the clinical profile of these infections. Molecular testing was conducted on nasopharyngeal samples taken from a respiratory surveillance cohort comprising adult (15-59 years) and elderly (60+ years) hospitalized patients who tested negative for SARS-CoV-2, to determine the prevalence for influenza and RSV. Influenza was found to be less frequent among the elderly. The main symptoms of RSV infections were cough, fever, dyspnea, malaise, and respiratory distress, while headache, nasal congestion, a sore throat, and myalgia were most frequent in influenza. Elderly patients with RSV were not found to have more severe illness than adults under age 60, underscoring the importance of providing the same care to adults with this viral infection.

Does vitamin D supplementation reduce the frequency or severity of respiratory viral infections in adults?

University of Chicago (NorthShore) Family Medicine Residency, Glenbrook, IL The corresponding author is Joseph Gibes; [email protected]. The authors declare no conflicts of interest.

Therapy of acute respiratory viral infections in adults in outpatient clinical practice: new opportunities for the prevention of bacterial complications (Results of the observational program RAPORT)

The frequency of routine prescription of systemic antibacterial drugs in outpatient practice is still unreasonably high despite the desire to reduce them. Under the auspices of the Alliance of Clinical Chemotherapists and Microbiologists, the observational program RAPORT was conducted to assess the therapeutic potential (including bacterial complications preventing) of Raphamin in routine clinical practice in adults with acute respiratory viral infection (ARVI). The program included 14,033 patients aged 1897 years with ARVI who received an investigational drug (ID) as monotherapy (93%) or in combination with basic therapy (7%). The frequency of prophylactic prescribing antibacterial drugs was 0.6%. It was shown that fever duration was 2.311.38 days, and the duration of the disease 3.61.52 days. In 99.4% of patients, ID allowed to avoid the development of bacterial complications and prescription of antibacterial drugs. ID showed a stable therapeutic effect in patients who started treatment late, as well as in patients with a moderate course of ARVI, there was no delay in recovery. The results obtained a broad prospect for the use of ID in order to minimize the number of bacterial complications and the frequency of use of antibiotics in ARVI, which may reduce rate of resistance of topical pathogens in the future.

WED-181 - Contrasting immune fingerprints of chronic hepatitis B Virus infection in adults from South Africa and the United Kingdom

WED-181 - Contrasting immune fingerprints of chronic hepatitis B Virus infection in adults from South Africa and the United Kingdom