Global Disease Burden Estimates of Respiratory Syncytial Virus–Associated Acute Respiratory Infection in Older Adults in 2015: A Systematic Review and Meta-Analysis

Abstract

Respiratory syncytial virus–associated acute respiratory infection (RSV-ARI) constitutes a substantial disease burden in older adults aged ≥65 years. We aimed to identify all studies worldwide investigating the disease burden of RSV-ARI in this population. We estimated the community incidence, hospitalization rate, and in-hospital case-fatality ratio (hCFR) of RSV-ARI in older adults, stratified by industrialized and developing regions, using data from a systematic review of studies published between January 1996 and April 2018 and 8 unpublished population-based studies. We applied these rate estimates to population estimates for 2015 to calculate the global and regional burdens in older adults with RSV-ARI in the community and in hospitals for that year. We estimated the number of in-hospital deaths due to RSV-ARI by combining hCFR data with hospital admission estimates from hospital-based studies. In 2015, there were about 1.5 million episodes (95% confidence interval [CI], .3 million–6.9 million) of RSV-ARI in older adults in industrialized countries (data for developing countries were missing), and of these, approximately 14.5% (214 000 episodes; 95% CI, 100 000–459 000) were admitted to hospitals. The global number of hospital admissions for RSV-ARI in older adults was estimated at 336 000 hospitalizations (uncertainty range [UR], 186 000–614 000). We further estimated about 14 000 in-hospital deaths (UR, 5000–50 000) related to RSV-ARI globally. The hospital admission rate and hCFR were higher for those aged ≥65 years than for those aged 50–64 years. The disease burden of RSV-ARI among older adults is substantial, with limited data from developing countries. Appropriate prevention and management strategies are needed to reduce this burden.

Pathophysiology of COVID-19: Why Children Fare Better than Adults?

“…Here also, the estimated CFR in adults >70 y is more than double of that in under-5s [12]. Other studies on RSV burden also estimate a lower incidence of RSV ALRI in adults >65 y as compared to under-5s and a multiple-fold higher hospital CFR in adults >65 y [13,14]. Among children, the youngest children (0-5 mo) had a higher incidence of RSV-related ALRI and higher hospitalization rates as compared to older children, but in-hospital CFR were similar in all age-groups in under-5s [14].…”

IL-17 production by tissue-resident MAIT cells is locally induced in children with pneumonia

“…Community-acquired pneumonia (CAP) is an immune-mediated lung disease caused by a wide variety of microbial pathogens. As a substantial cause of morbidity and mortality in children under 5 years of age, CAP remains a major public health burden, particularly in developing countries [24][25][26] . Severe CAP is associated with acute respiratory and cardiovascular failure, multiple organ dysfunction, and high mortality 27 .…”

Epidemiology and genetic variability of respiratory syncytial virus in Portugal, 2014–2018

“…RSV is associated with substantial morbidity and mortality since it is the major cause of lower respiratory tract infections (LRTI) during childhood resulting in hospitalization due to the severity of infection in many cases [12]. Moreover, it causes severe respiratory tract infection in adults, especially elderly, and immunosuppressed patients [13,14]. Symptomatic supportive care and Palivizumab are currently available options to RSV disease clinical management, which reduce the symptoms and severity, decreasing hospitalization rate but not mortality [15][16][17][18].…”