Estimating the burden of adult hospital admissions due to RSV and other respiratory pathogens in England

Sharp, Ashley; Minaji, Mehdi; Panagiotopoulos, Nikolaos; Reeves, Rachel M; Charlett, André; Pebody, Richard

doi:10.1111/irv.12910

Cited by 28 publications

(26 citation statements)

References 25 publications

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“…Two of the eligible studies provided estimates only for infants and data from these studies were not included in this analysis. We found three eligible studies providing new estimates for England [21][22][23], but because there were recent RESCEU estimates for England, the new estimates found from the literature were not included as input data for Stage 2. The search records of RSV-associated hospitalisation estimates are outlined in a PRISMA flowchart (Figure 1).…”

Section: Scoping Literature Reviewmentioning

confidence: 99%

Estimation of the number of RSV-associated hospitalisations in adults in the European Union

Osei‐Yeboah

Spreeuwenberg

Riccio

et al. 2023

Preprint

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Background: Respiratory syncytial virus (RSV) is a major cause of lower respiratory tract infections in older adults that can result in hospitalisations and death. Estimating RSV-associated hospitalisation is critical for planning RSV-related healthcare needs for the ageing population across Europe. Methods: We gathered national RSV-associated hospitalisation estimates from the REspiratory Syncytial virus Consortium in EUrope (RESCEU) for adults in Denmark, England, Finland, Norway, Netherlands, and Scotland from 2006 to 2017. We extrapolated these estimates to 28 EU countries using nearest-neighbour matching, multiple imputations, and two sets of 10 indicators. Results: On average, 158 229 (95%CI: 140 865, 175 592) RSV-associated hospitalisations occur annually among adults in the EU (above 18 years); 92% of these hospitalisations occur in adults over 65 years. Among 75-84 years old, the annual average is estimated at 74 519 (95%CI: 69 923, 79 115) at a rate of 2.24 (95%CI: 2.10, 2.38) per 1000 adults. Among adults aged 85 years and above, the annual average is estimated at 37 904 (95%CI: 32 444, 43 363) at a rate of 2.99 (95%CI: 2.56, 3.42). Conclusion: Our estimates of RSV-associated hospitalisations in older adults are the first analysis integrating available data to provide estimates of the disease burden in this population across the EU. Importantly, for a condition which was considered in the past to be primarily a disease of young children, the average annual hospitalisation estimate in adults was lower but of a similar magnitude to the estimate in young children aged 0-4 years: 158 229 (95%CI: 140 865, 175 592) versus 245 244 (95%CI: 224 688, 265 799).

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Section: Scoping Literature Reviewmentioning

confidence: 99%

Estimation of the number of RSV-associated hospitalisations in adults in the European Union

Osei‐Yeboah

Spreeuwenberg

Riccio

et al. 2023

Preprint

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“…We used the contact matrix [24] from the United Kingdom as a case study representing northern hemisphere countries with strong seasonality of RSV (SI Figure 1). The risk for hospitalisation upon infection was modelled specific to the age groups based on estimates from the UK (SI Table 3) [25][26][27][28], using the estimates on risk per infection from [13] as default values. The hospitalisation per infection values from [13] for the <1-year and over-45 groups were adjusted to fit the age-specific population-based hospitalisation estimates (SI Table 4, SI Figure 5), which was necessary because of a less detailed description of maternal immunity and the absence of asymptomatic infections in the current model, respectively.…”

Section: Parameter Estimatesmentioning

confidence: 99%

Determinants of RSV epidemiology following suppression through pandemic contact restrictions

Koltai

Krauer

Hodgson

et al. 2021

Preprint

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Introduction COVID-19 related non-pharmaceutical interventions (NPIs) led to a suppression of RSV circulation in winter 2020/21 throughout Europe and an off-season resurgence in Summer 2021 in several European countries. We explore how such temporary interruption may shape future RSV epidemiology and what factors drive the associated uncertainty. Methods We developed an age-structured dynamic transmission model to simulate pre-pandemic RSV infections and hospitalisations. We sampled parameters governing RSV seasonality, immunity acquisition and duration of post-infection immunity and retained those simulations that qualitatively fit the UK's pre-pandemic epidemiology. From Spring 2020 to Summer 2021 we assumed a 50% reduced contact frequency, returning to pre-pandemic levels from mid-May 2021. We simulated transmission forwards until 2023 and evaluated the impact of the sampled parameters on the projected trajectories of RSV hospitalisations. Results Following a lifting of contact restrictions in summer 2021 the model replicated an out-of-season resurgence of RSV. If unmitigated, paediatric RSV hospitalisation incidence in the 2021/22 season was projected to increase by 32% to 67% compared to pre-pandemic levels. The size of the increase depended most on whether infection risk was primarily determined by immunity acquired from previous exposure or general immune maturation. While infants were less affected, the increase in seasonal hospitalisation incidence exceeded 100% in 1-2 year old children and 275% in 2-5 year old children, respectively, in some simulations where immunity from previous exposure dominated. Consequently, the average age of a case increased by 1 to 5 months, most markedly if there was strong immunity acquisition from previous exposure. If immunity to infection was largely determined by age rather than previous exposure, the 2021/22 season started earlier and lasted longer but with a peak incidence lower or similar to pre-pandemic levels. For subsequent seasons, simulations suggested a quick return to pre-pandemic epidemiology, with some slight oscillating behaviour possible depending on the strength of post-exposure immunity. Conclusion COVID-19 mitigation measures stopped RSV circulation in the 2020/21 season and generated immunity debt that will likely lead to a temporary increase in RSV burden in the season following the lifting of restrictions, particularly in 1 to 5 year old children. A more accurate understanding of immunity drivers for RSV is needed to better predict the size of such an increase and plan a potential expansion of pharmaceutical and non-pharmaceutical mitigation measures.

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“…As shown in Figure 1, among 2295 records initially screened, 74 were retrieved as full texts. After excluding some works, mainly because data were not meta-analyzable (Table S1 reports the references and the reason of the exclusion), 16 papers were finally included [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38].…”

Section: Search Resultsmentioning

confidence: 99%

Rate of Hospitalizations and Mortality of Respiratory Syncytial Virus Infection Compared to Influenza in Older People: A Systematic Review and Meta-Analysis

et al. 2022

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Respiratory Syncytial Virus (RSV) is commonly regarded as an infection typical of children, but increasing literature is showing its importance in older people. Since the data regarding the impact of RSV are still limited for older people, the aim of this systematic review and meta-analysis is to compare the rate of hospitalization and mortality between RSV and influenza in this population. A systematic literature search until 15 June 2022 was done across several databases and including studies reporting incidence rate and cumulative incidence of hospitalization and mortality in RSV and influenza affecting older people. Among 2295 records initially screened, 16 studies including 762,084 older participants were included. Compared to older patients having influenza, patients with RSV did not show any significant different risk in hospitalization (either cumulative or incidence rate). Similar results were evident for mortality. The quality of the studies was in general good. In conclusion, our systematic review and meta-analysis showed that the rate of hospitalization and mortality was similar between RSV and influenza in older adults, suggesting the importance of vaccination for RSV in older people for preventing negative outcomes, such as mortality and hospitalization.

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Estimating the burden of adult hospital admissions due to RSV and other respiratory pathogens in England

Cited by 28 publications

References 25 publications

Estimation of the number of RSV-associated hospitalisations in adults in the European Union

Estimation of the number of RSV-associated hospitalisations in adults in the European Union

Determinants of RSV epidemiology following suppression through pandemic contact restrictions

Rate of Hospitalizations and Mortality of Respiratory Syncytial Virus Infection Compared to Influenza in Older People: A Systematic Review and Meta-Analysis

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