Disease Burden Estimates of Respiratory Syncytial Virus related Acute Respiratory Infections in Adults With Comorbidity: A Systematic Review and Meta-Analysis

Abstract

Background Respiratory syncytial virus related acute respiratory infection (RSV-ARI) constitutes a substantial disease burden in adults with comorbidities. We aimed to identify all studies investigating the disease burden of RSV-ARI in this group. Methods We estimated the incidence, hospitalization rate, and in-hospital case fatality ratio (hCFR) of RSV-ARI in adults with comorbidities based on a systematic review of studies published between January 1996 and March 2020. We also investigated the association between RSV-ARI and any comorbidity in adults. Meta-analyses based on random effects model were carried out. Results Overall, 20 studies were included. The annual incidence rate of RSV-ARI in adults with any comorbidity was 37.6 (95% confidence interval [CI], 20.1–70.3) per 1000 persons per year in industrialized countries and the seasonal incidence rate was 28.4 (11.4–70.9) per 1000 persons per season. The hCFR in industrialized countries was 11.7% (5.8%–23.4%). There were no studies in developing countries. There were insufficient data to generate the meta-estimate of hospitalization rate. The likelihood of experiencing RSV-ARI for those with any comorbidity compared to those without was estimated to be 4.1 (odds ratio [OR], 1.6–10.4) and 1.1 (OR, 0.6–1.8) from studies using univariable and multivariable analysis respectively. Conclusion The disease burden of RSV-ARI among adults with comorbidity is substantial with limited data available.

Burden of respiratory syncytial virus infection in older and high-risk adults: a systematic review and meta-analysis of the evidence from developed countries

“…The annual incidence of RSV in high-risk adults was similar to that recently estimated out of community cohort studies in adults aged years with any comorbidity with ARI in industrialised countries (37.6, 95% CI 20.1-70.3 RSV cases per 1000 persons per year) [35]. However, in seasonal studies, we estimated a nine-fold higher incidence, as reported previously by SHI et al [35] (260.89, 95% CI 82.33-826.65 RSV cases per 1000 persons per year compared to 28.4, 95% CI 11.4-70.9 RSV cases per 1000 persons per year, respectively). This difference might be driven by the inclusion of studies on cohorts of immunocompromised patients in our analysis, such as an outpatient cohort of adult bone marrow or peripheral blood stem cell transplant recipients with mild RSV manifestation [36].…”

“…This indicates the higher risk of severe disease and poor outcome in high-risk patients, especially among immunodeficient patients. among immunodeficient adults, demonstrating similar results to those recently estimated for mostly immunocompetent RSV-ARI high-risk adults (11.7%, 95% CI 5.8-23.4%) [35]. According to another study, cumulative mortality consistently increases after hospitalisation, reaching 25.8% in adults aged ⩾60 years after 1 year of admission [9].…”

Direct RNA sequencing of respiratory syncytial virus infected human cells generates a detailed overview of RSV polycistronic mRNA and transcript abundance

“…Recovery from infection does not lead to long term protection and repeat reinfections over an individual's lifetime are a hallmark of RSV [3,4]. Thus, hospital admission of elderly patients with lifethreatening complications of RSV infection are also common [5,6]. Typically, RSV represents a global viral respiratory disease burden comparable to that of influenza, highlighting the importance of understanding this virus' lifecycle [7][8][9].…”

Correlation between national surveillance and search engine query data on respiratory syncytial virus infections in Japan

“…Respiratory syncytial virus (RSV) is a common cause of acute respiratory tract illness [1][2][3]. The disease burden is significant, especially in infants and patients with an underlying disease, including premature infants and children with a chronic lung disease, congenital heart failure, immunocompromised status, etc.…”