Study Design, Sites, and Participants
From October 2017 to April 2018 (Year 1) and from October 2018 to April
2019 (Year 2), we performed prospective surveillance among hospitalized
adults 18 years of age and older who had laboratory-confirmed RSV
infection. Surveillance occurred at three academically affiliated
hospitals from the same multi-campus institution. The hospitals were
located in Northern Manhattan and included a ~750-bed
tertiary care hospital for adult patients, a ~200-bed
community hospital for adult patients, and a ~250-bed
children’s hospital. The Columbia University Irving Medical Center
Institutional Review Board approved this study with a waiver of
documentation of consent.
As per the standard of care in these hospitals, patients with acute
respiratory infections (ARI) and anticipated hospitalization are tested
for viral respiratory pathogens to inform infection prevention and
control and influenza treatment. These tests are most often performed in
the emergency department (ED). Nasopharyngeal swabs are processed in the
clinical microbiology laboratories affiliated with these hospitals using
a multiplex reverse transcription polymerase chain reaction (PCR) assay
(FilmArray Respiratory Panel, BioFire Diagnostics, Inc., Salt Lake City,
UT) which includes RSV on the panel. Potential patients were identified
during the prospective surveillance study by monitoring admissions from
the ED (Monday through Friday) and by reviewing the Department of
Infection Prevention and Control’s internal database of
epidemiologically significant pathogens in hospitalized patients. Since
surveillance did not occur during weekends or holidays, at the end of
each surveillance period, the electronic medical records (EMR) of all
hospitalized adults were queried to identify any additional patients
with positive RSV tests who may have been missed by active surveillance.
Eligible patients for the current study were 18 years and older, had
laboratory-confirmed RSV infection, two or more symptoms consistent with
ARI (fever, cough, shortness of breath, sore throat, headache, malaise,
myalgia, sputum production, wheezing, hoarseness, and/or pleuritic chest
pain) documented in the EMR, were hospitalized for at least 24 hours,
and lived in New York City as per their residential zip code.