The prevention of infectious diseases in older adults remains a major public health challenge, as acute respiratory infections are a leading cause of hospitalisation, mortality, and functional decline worldwide. Immunosenescence and environmental exposures increase susceptibility to infection and reduce vaccine effectiveness in this population. Respiratory viruses, including influenza, SARS-CoV-2, respiratory syncytial virus, and human metapneumovirus, account for a substantial share of this burden, much of which is vaccine-preventable. However, their impact on functional decline and recovery in older adults remains insufficiently characterized. This international study aims to assess the effect of hospitalization for major respiratory viral infections on loss of autonomy in individuals aged 60 years and older, to inform targeted prevention and vaccination strategies.
The prevention of infectious diseases in older adults represents a major public health challenge due to their substantial impact on morbidity, mortality, and loss of functional capacity. Acute respiratory infections are among the leading causes of hospitalization and death in this population worldwide. Ageing is associated with a progressive decline in immune function, resulting in increased susceptibility to infections and reduced vaccine effectiveness. In addition, environmental factors such as residence in collective living settings and repeated exposure to healthcare environments further increase the risk of exposure to and transmission of infectious agents. The pathogens most frequently involved include respiratory viruses namely influenza, SARS-CoV-2, respiratory syncytial virus, and human metapneumovirus as well as bacterial pathogens, particularly Streptococcus pneumoniae, and certain fungal agents. A substantial proportion of these infections are potentially preventable through vaccination. Despite advances generated by the European IMI VITAL project and the AEQUI case-control study, data remain limited regarding the functional consequences of acute respiratory infections in older adults, particularly their impact on dependency, frailty, and post-infectious recovery. This international study aims to address these knowledge gaps by evaluating the impact of hospitalizations related to influenza, SARS-CoV-2, respiratory syncytial virus, and human metapneumovirus on loss of autonomy in individuals aged 60 years and older. The findings are expected to strengthen the scientific evidence base needed to inform targeted vaccination and prevention strategies, ultimately contributing to healthier ageing.
Study Type
OBSERVATIONAL
Enrollment
1,600
University of Rochester School of Medicine, Infectious Diseases Unit
Rochester, New York, United States
University Hospital of Amiens
Amiens, France
Melun Hospital
Melun, France
Villeneuve Saint Georges Hospital
Paris, France
University Hospital of Poitiers
Poitiers, France
University Hospital of Reims
Reims, France
University Hospital of Tours
Tours, France
Klinikum Bayreuth, Klinik für Geriatrie
Bayreuth, Germany
Abteilung Geriatrie Universitätsmedizin Göttingen, Abteilung Geriatrie
Göttingen, Germany
Uniklinikum Jena, Klinik für Geriatrie
Jena, Germany
...and 14 more locations
Evolution of Functional Dependency assessed by Activities of Daily Living (ADL) Score
Change in functional performance measured using the Activities of Daily Living (ADL) scale. The ADL score ranges from 0 to 6, where higher scores indicate better functional independence The ADL score ranges from 0 to 6, where higher scores indicate better functional independence.
Time frame: Baseline, at hospital discharge, 3 months after discharge, and 6 months after discharge.
Evolution of Functional Dependency assessed by Instrumental Activities of Daily Living (IADL) Score
Change in functional performance measured using the Instrumental Activities of Daily Living (IADL) scale. The IADL score ranges from 0 to 8, where higher scores indicate better functional independence.
Time frame: Baseline, Day 7, 3 months after discharge, and 6 months after discharge.
Functional Status depending on Viral Etiology Assessed by Activities of Daily Living (ADL) Score
Change in functional status measured using the Activities of Daily Living (ADL) scale. The ADL score ranges from 0 to 6, where higher scores indicate better functional independence. Changes in score will be assessed between baseline, hospital discharge, 3 months, and 6 months, and stratified by viral etiology (SARS-CoV-2, influenza, respiratory syncytial virus (RSV), and human metapneumovirus (hMPV)).
Time frame: Baseline, Day 7, 3 months after discharge, and 6 months after discharge.
Functional Status depending on Viral Etiology Assessed by Instrumental Activities of Daily Living (IADL) Score
Change in functional status measured using the Instrumental Activities of Daily Living (IADL) scale. The IADL score ranges from 0 to 8, where higher scores indicate better functional independence. Changes in score will be assessed between baseline, hospital discharge, 3 months, and 6 months, and stratified by viral etiology (SARS-CoV-2, influenza, respiratory syncytial virus (RSV), and human metapneumovirus (hMPV)).
Time frame: Baseline, Day 7, 3 months after discharge, and 6 months after discharge.
Medical Complications during and after hospitalization
Occurrence of medical complications during hospitalization and up to 6 months after discharge, including new diagnoses identified during follow-up.
Time frame: From hospital admission to 6 months after discharge.
Health Care Resource Utilization (HCRU)
Health care resource utilization, including hospital length of stay, intensive care unit (ICU) admission during index hospitalization, and hospital readmissions occurring between discharge and 6 months.
Time frame: From hospital admission to 6 months after discharge.
Length of Hospital Stay
Duration of the index hospitalization, measured in days, calculated from hospital admission (Day 1) to hospital discharge.
Time frame: 3 months after discharge
Intensive Care Unit (ICU) Admission
Proportion of participants admitted to an intensive care unit during the index hospitalization.
Time frame: 3 months after hospital discharge.
Hospital Readmissions After Discharge
Occurrence of hospital readmissions between discharge and 6 months after discharge.
Time frame: From at hospital discharge to 6 months after discharge.
New Medications Initiated
Initiation of new drug treatments during hospitalization or within 6 months after discharge.
Time frame: From hospital admission to 6 months after discharge.
Discharge Location after Hospitalization
Location at hospital discharge (e.g., home, rehabilitation facility, long-term care facility).
Time frame: 3 months after hospital discharge.
Living Situation at 6 Months after Discharge
Living situation of participants at 6 months after hospital discharge
Time frame: 6 months after hospital discharge.
Demographic Characteristics of Participants
Baseline demographic characteristics of participants, including age and sex.
Time frame: Baseline.
Living Situation at Baseline
Living situation of participants prior to hospital admission.
Time frame: Baseline.
Prevalence of Comorbidities
Prevalence of pre-existing comorbidities at baseline.
Time frame: Baseline.
Vaccination Status
Proportion of participants vaccinated against influenza, SARS-CoV-2, and respiratory syncytial virus (RSV).
Time frame: Baseline.
Time since last vaccination
Time elapsed since the most recent vaccination against influenza, SARS-CoV-2, or RSV, measured in months.
Time frame: Baseline.
Pneumonia Severity Index (PSI) Score
Severity of pneumonia assessed using the Pneumonia Severity Index (PSI) score at hospital admission.
Time frame: Baseline
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.