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Incidence and outcomes of hospital-associated respiratory virus infections by viral species

Published online by Cambridge University Press:  11 December 2023

Joshua G. Petrie Open the ORCID record for Joshua G. Petrie [Opens in a new window] ,
Riley Moore ,
Adam S. Lauring Open the ORCID record for Adam S. Lauring [Opens in a new window]  and
Keith S. Kaye
Joshua G. Petrie*
Affiliation:
Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin
Riley Moore
Affiliation:
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan
Adam S. Lauring
Affiliation:
Department of Microbiology and Immunology and Division of Infectious Diseases, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
Keith S. Kaye
Affiliation:
Division of Allergy, Immunology and Infectious Diseases, Department of Medicine, Rutgers Robert Wood Johnson School of Medicine, New Brunswick, New Jersey
*
Corresponding author: Joshua G. Petrie; Email: petrie.joshua@marshfieldresearch.org
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Abstract

Background:

Although the incidence of hospital-associated respiratory virus infection (HARVI) is well recognized, the risk factors for infection and impact on patient outcomes are not well characterized.

Methods:

We identified a cohort of all inpatient admissions ≥24 hours duration at a single academic medical center from 2017 to 2020. HARVI were defined as respiratory virus detected in a test ordered after the 95th percentile of the virus-specific incubation period. Risk factors for HARVI were assessed using Cox proportional hazards models of the competing outcomes of HARVI and discharge. The associations between time-varying HARVI status and the rates of ICU admission, discharge, and in-hospital death were estimated using Cox-proportional hazards models in a competing risk framework.

Results:

HARVI incidences were 8.8 and 3.0 per 10,000 admission days for pediatric and adult patients, respectively. For adults, congestive heart failure, renal disease, and cancer increased HARVI risk independent of their associations with length of stay. HARVI risk was also elevated for patients admitted in September–June relative to July admissions. For pediatric patients, cardiovascular and respiratory conditions, cancer, medical device dependence, and admission in December increased HARVI risk. Lengths of stay were longer for adults with HARVI compared to those without, and hospital-associated influenza A was associated with increased risk of death. Rates of ICU admission were increased in the 5 days after HARVI identification for adult and pediatric patients. HARVI was not associated with length of stay or death among pediatric patients.

Conclusions:

HARVI is associated chronic health conditions and increases morbidity and mortality.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 45 , Issue 5 , May 2024 , pp. 618 - 629
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Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

PREVIOUS PRESENTATION. These data were presented in poster 640 at the Society for Healthcare Epidemiology of America Spring Conference on April 14, 2023, in Seattle, Washington.

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