Respiratory syncytial virus hospitalization in middle-aged and older adults

Abstract

Background The importance of Respiratory Syncytial Virus (RSV) is increasingly recognized in hospitalized adults, but mainly in those ≥ 65 years. Objectives We sought to describe the epidemiology and clinical severity of RSV compared to influenza in hospitalized adults ≥18 years. Study Design Adults hospitalized with acute respiratory illnesses (ARI) of ≤10 days duration were prospectively enrolled from two Michigan hospitals during two influenza seasons. Collected specimens were tested for RSV and influenza by real-time, reverse transcription polymerase chain reaction (RT-PCR). Viral load and subtype were determined for RSV-positive specimens. We evaluated factors associated with RSV and outcomes of infection using multivariable logistic regression. RSV-positive patients were separately compared to two reference groups: RSV-negative and influenza-negative, and influenza-positive patients. Results RSV was detected in 84 (7%) of 1259 hospitalized individuals (55 RSV-B, 29 RSV-A). The highest prevalence was found in 50-64 year olds (40/460; 8.7%); 98% of RSV cases in this age group had at least one chronic comorbidity. RSV detection was associated with obesity (OR: 1.71 95% CI: 0.99-3.06, p=0.03). Individuals with RSV were admitted to the hospital later in their illness and had a higher median Charlson comborbidity index (3 vs 2 p < 0.001) compared to those with influenza. Clinical severity of RSV-associated hospitalizations was similar to influenza-associated hospitalizations. Discussion In this study we observed the highest frequency of RSV-associated hospitalizations among adult 50-64 years old; many of whom had chronic comorbidities. Our results suggest the potential benefit of including these individuals in future RSV vaccination strategies.

Clinical manifestations and outcomes of respiratory syncytial virus infection in adult hospitalized patients

“…The major comorbidities were pre-existing cardiopulmonary diseases, hematologic malignancy, immunocompromised hosts and DM. These findings were similar to the results of previous studies [4,6,11,19,21]. RSV infection is a seasonal disease [3,22,23].…”

“…Most (87.0%) adult hospitalized patients with RSV infection of age ≥ 50 years had comorbidities. RSV is an important pathogen not only in patients of age ≥ 65 years but also in the age range 50-64 years, which was similar to previous studies [9,19,20]. Nevertheless, we found the highest prevalence in age range 65-79 years (36.2%).…”

Evaluation of using ICD‐10 code data for respiratory syncytial virus surveillance

“…is a common pathogen of ARI in older adults and can lead to severe disease. 29,30 Therefore, the RSV infections were probably underestimated among older adults in SEED ARE . This could be another limitation.…”

Seroepidemiology of respiratory syncytial virus in western India with special reference to appropriate age for infant vaccination

“…Another important concern is RSV infection among the elderly and the resultant hospitalizations . In the absence of data on RSV infection among adults from India, this study determined the prevalence of IgG‐anti‐RSV antibodies in the adult population.…”

“…The importance of RSV in hospitalizations of the elderly is being increasingly recognized . As far as India is concerned, recent hospital‐based, multicentric studies have documented the significant contribution of RSV in causing respiratory diseases in infants/children from different parts of the country .…”