Comparison of mortality and outcomes of four respiratory viruses in the intensive care unit: a multicenter retrospective study
Baptiste Grangier, Charles-Hervé Vacheron, Donatien De Marignan, Jean-Sebastien Casalegno, Sandrine Couray-Targe, Audrey Bestion, Florence Ader, Jean-Christophe Richard, Emilie Frobert, Laurent Argaud, Thomas Rimmele, Anne-Claire Lukaszewicz, Frédéric Aubrun, Frédéric Dailler, Jean-Luc Fellahi, Julien Bohe, Vincent Piriou, Bernard Allaouchiche, Arnaud Friggeri, Florent Wallet, Fabrice Thiolliere, Emilie Joffredo, Lucille Jay, Marie Darien, Jean-Stéphane David, Charlotte Cerruti, Maxime Lecocq, Guillaume Izaute, Thomas Collenot, Olivia Vassal
Scientific Reports, doi:10.1038/s41598-024-55378-x
This retrospective study aimed to compare the mortality and burden of respiratory syncytial virus (RSV group), SARS-CoV-2 (COVID-19 group), non-H1N1 (Seasonal influenza group) and H1N1 influenza (H1N1 group) in adult patients admitted to intensive care unit (ICU) with respiratory failure. A total of 807 patients were included. Mortality was compared between the four following groups: RSV, COVID-19, seasonal influenza, and H1N1 groups. Patients in the RSV group had significantly more comorbidities than the other patients. At admission, patients in the COVID-19 group were significantly less severe than the others according to the simplified acute physiology score-2 (SAPS-II) and sepsis-related organ failure assessment (SOFA) scores. Using competing risk regression, COVID-19 (sHR = 1.61; 95% CI 1.10; 2.36) and H1N1 (sHR = 1.87; 95% CI 1.20; 2.93) were associated with a statistically significant higher mortality while seasonal influenza was not (sHR = 0.93; 95% CI 0.65; 1.31), when compared to RSV. Despite occurring in more severe patients, RSV and seasonal influenza group appear to be associated with a more favorable outcome than COVID-19 and H1N1 groups.
Ethics approval and consent to publications This study was conducted in accordance with the amended Declaration of Helsinki and was approved by the institutional ethics committee (Scientific and Ethical Committee of the Hospices Civils de LYON, CSE-HCL, under reference N° 21-505). It reviewed that the study was in strict compliance with the French reference methodology MR-004 established by the French national data protection commission (Commission nationale de l'informatique et des libertés, CNIL, under reference N° 21_5505). Non-opposition for data use was obtained
Discussion In this large retrospective cohort study, adjusted mortality at day-90 was significantly higher in the H1N1 and COVID-19 groups than for those in the RSV and seasonal influenza groups. At admission, the clinical presentation and laboratory parameters differed according to the infecting virus. Patients in the RSV group had more comorbidities, especially respiratory, and those in the COVID-19 group were the least severe at admission. The evolution of patients also differed as patients in the COVID-19 and H1N1 group present with more severe organ failure, especially respiratory, during the ICU stay. This strongly suggests that RSV and seasonal influenza intrinsically induce less severe pneumonia in more comorbid patients, as previously suggested 9 . The present study is one of the largest comparing RSV with other CARV in an adult ICU population and the first to include SARS-CoV-2. Until now, only a..
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