UNIVERSAL is a prospective observational study of hospitalised adults with symptoms of acute respiratory illness and PCR evidence of RVI. We present preliminary results from the lead centre.

Our hypothesis is clinical variables can estimate risk of severity and length of stay in hospitalised adults with RVI.

Methods:

We studied 98 adults admitted with respiratory illness and a positive PCR for acute RVI. Clinical characteristics were collected prospectively. Multivariable logistic regression was utilised to calculate the OR and 95% CI associated with admission supplemental oxygen requirement, CXR changes, and length of stay greater than the median. Adjustments included age, sex, virus type, comorbidities, smoking status, vaccination status, white cell count > 11, neutrophils >8.5, lymphocyte <1.5 (units 109/L), CRP >20mg/L.

Results:

RVIs included Influenza A 34, RSV 22, SARS-Co-V-2 18, Rhinovirus 16, HMPV 2, PIV 3, viral co-infection 3. The median age was 67 (IQR 21), median length of stay 4 days (IQR 4), 44.9% were male, 65.3% required supplemental O2, 46.9% had new CXR infiltrates on admission. Comorbid COPD was a risk factor for length of stay >4 days (OR 4.83 1.20-21.76.). Comorbid Asthma (OR 5.86 1.33-30.41), neutrophil count >8.5 (OR 25.24 1.31-1122) and CRP>20 (OR 6.82 1.92-28.82) increased the risk of new CXR infiltrates on admission. There was no difference in supplemental oxygen requirement on admission for any of the listed variables.

Conclusion: RVI admissions are associated with a range of viral pathogens. Clinical characterisation of admissions highlights the importance of co-morbidity in impacting severity and outcome.