摘要
The burden of respiratory syncytial virus(RSV)disease is widely recognized.Main risk factors for severe disease,such as extreme ages,chronic cardiopulmonary conditions,and immunosuppression,typically coincide withpoorer outcomes.While the majority of RSV hospitalizations involve healthy children,a higher proportion ofhospitalized adults with underlying conditions need intensive care.Presently,treatment primarily consists ofsupportive measures.RSV-induced wheezing should be distinguished from respiratory tract thickening,withoutresponse to bronchodilators.Obstructive RSV disease frequently overlaps with viral pneumonia.Non-invasivemechanical ventilation and high-flow oxygen therapy represented significant advancements in the managementof severe RSV disease in children and may also hold considerable importance in specific phenotypes of RSV diseasein adults.Most severe infections manifest with refractory hypoxemia necessitating more advanced ventilatorysupport and/or extracorporeal membrane oxygenation therapy.Although bacterial co-infection rates are low,they have been associated with worse outcomes.Antibiotic prescription rates are high.Accurately diagnosingbacterial co-infections remains a challenge.Current evidence and antibiotic stewardship policies advise againstindiscriminate antibiotic usage,even in severe cases.The role of currently developing antiviral therapies in severeRSV disease will be elucidated in the coming years,contingent upon the success of new vaccines and immunepassive strategies involving nirsevimab.
