The three letters RSV (Respiratory Syncytial Virus) have now become a common point of discussion in the exam room and elsewhere. Infections with this virus used to be primarily a pediatric concern. In 2019 RSV was associated with 100,000 deaths in children under the age of 5 worldwide. Now patients greater than 70 years of age have a 7 times greater chance of dying from an RSV infection.
High income countries are at increased risk of developing RSV epidemics due to the combination of an aging population and increased comorbidities. RSV infections occur more frequently in patients with chronic obstructive pulmonary disease and more patients with COPD are experiencing exacerbations due to RSV. A recent study in a well-defined group of COPD patients in the United Kingdom and Netherlands revealed that 8.7% of the outpatient managed COPD exacerbations were due to RSV.
Although there is no specific treatment at this time for RSV, from an epidemiologic as well as a medical standpoint, making an accurate diagnosis is vital. Currently, there is no one test that can be relied upon for a high degree of accuracy and specificity. The use of the common nasal swab has a number of limitations.
One additional interesting aspect is the persistence of the virus in stable COPD patients. RSV has been found in stable COPD patients with reported increased levels of airway inflammation and reductions in airflow measurements.
If you are older and, especially, if you have lung disease strongly consider vaccination.
