Respiratory syncytial virus disease burden in adults aged 60 years and older in high‐income countries: A systematic literature review and meta‐analysis

Abstract

Background: Respiratory syncytial virus (RSV)-associated acute respiratory infection (ARI) is an underrecognized cause of illness in older adults. We conducted a systematic literature review and meta-analysis to estimate the RSV disease burden in adults ≥60 years in high-income countries.Methods: Data on RSV-ARI and hospitalization attack rates and in-hospital case fatality rates (hCFR) in adults ≥60 years from the United States, Canada, European countries, Japan, and South Korea were collected based on a systematic literature search (January 1, 2000-November 3, 2021) or via other methods (citation search, unpublished studies cited by a previous meta-analysis, gray literature, and an RSVspecific abstract booklet). A random effects meta-analysis was performed on estimates from the included studies.Results: Twenty-one studies were included in the meta-analysis. The pooled estimates were 1.62% (95% confidence interval [CI]: 0.84-3.08) for RSV-ARI attack rate, 0.15% (95% CI: 0.09-0.22) for hospitalization attack rate, and 7.13% (95% CI: 5.40-9.36) for hCFR. In 2019, this would translate into approximately 5.2 million cases, 470,000 hospitalizations, and 33,000 in-hospital deaths in ≥60-year-old adults in high-income countries.Conclusions: RSV disease burden in adults aged ≥60 years in high-income countries is higher than previously estimated, highlighting the need for RSV prophylaxis in this age group.

The Quest for a Respiratory Syncytial Virus Vaccine for Older Adults: Thinking beyond the F Protein

“…In the United Kingdom, RSV-attributable respiratory disease is estimated to cause 83 paediatric deaths per average season [ 2 ]; this rises to 8482 deaths per year among adults aged ≥18 years, with 93% of those cases occurring in older adults aged ≥65 years [ 3 ]. A recent meta-analysis estimated that 5.2 million cases of RSV occurred in high-income countries among adults aged ≥60 years in 2019, leading to 470,000 hospitalisations and 33,000 in-hospital deaths [ 4 ]. Limited epidemiological data are available for developing countries [ 4 , 5 ].…”

“…A recent meta-analysis estimated that 5.2 million cases of RSV occurred in high-income countries among adults aged ≥60 years in 2019, leading to 470,000 hospitalisations and 33,000 in-hospital deaths [ 4 ]. Limited epidemiological data are available for developing countries [ 4 , 5 ]. These figures are likely to be underestimated as they only consider those admitted to hospital, omitting those without access to care and those with suboptimal healthcare-seeking behaviour [ 5 ].…”

Respiratory Viruses and Virus-like Particle Vaccine Development: How Far Have We Advanced?

“…The virus is not only a threat to infants but also to adults with comorbidities as well, especially individuals with chronic cardiopulmonary diseases [ 73 ]. Furthermore, most recent meta-analyses revealed that RSV-related case fatality proportions for individuals over 60 years of age residing in developed countries was approximately 8% [ 74 ], with an estimated 33,000 in-hospital deaths due to acute RSV infection [ 75 ].…”

Burden of Influenza and Respiratory Syncytial Viruses in Suspected COVID-19 Patients: A Cross-Sectional and Meta-Analysis Study

“…Human orthopneumovirus (previously known as the respiratory syncytial virus (RSV)) is another serious respiratory pathogen that is frequently a cause of hospital admissions related to bronchitis, bronchiolitis, and pneumonia, particularly in children, seniors, or immunocompromised patients [ 11 , 12 , 13 ]. In 2019, RSV infection, including only ≥60-year-old adults in high-income countries, was estimated to encompass approximately 5 million cases, including 33,000 in-hospital deaths [ 14 ]. These findings show the impact of SARS-CoV-2, FluV, and RSV seasonality on the global burden of infectious diseases.…”