Respiratory Syncytial Virus Sequelae Among Adults in High-Income Countries: A Systematic Literature Review and Meta-analysis

Ubamadu, Egbe; Betancur, Estefania; Gessner, Bradford D.; Menon, Sonia; Vroling, Hilde; Curcio, Daniel; Rozenbaum, Mark; Kurosky, Samantha K.; Aponte, Zuleika; Begier, Elizabeth

doi:10.1007/s40121-024-00974-7

Cited by 4 publications

References 55 publications

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Estimated Vaccine Effectiveness for Respiratory Syncytial Virus–Related Lower Respiratory Tract Disease

Tartof,

Aliabadi,

Goodwin

et al. 2024

JAMA Netw Open

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ImportanceClinical trials have demonstrated high vaccine efficacy (VE) against lower respiratory tract disease (LRTD) but enrolled a smaller proportion of persons aged 75 years or older and those with comorbidities than seen in highest-risk populations in clinical practice settings. Additionally, VE against respiratory syncytial virus (RSV)–related hospitalizations and emergency department (ED) visits is not yet fully described.ObjectiveTo estimate Respiratory Syncytial Virus Prefusion F (RSVpreF) effectiveness in older adults.Design, Setting, and ParticipantsThis was a retrospective case-control study with a test negative design. Cases were adults aged 60 years or older with hospitalizations or ED visits at Kaiser Permanente of Southern California for LRTD from November 24, 2023, to April 9, 2024, who had respiratory swabs collected and tested for RSV. Two control definitions were prespecified: (1) strict controls included RSV-negative LRTD events that were negative for human metapneumovirus, SARS-CoV-2, and influenza, and positive for a nonvaccine preventable cause (primary) and (2) broad controls included all RSV-negative LRTD events (sensitivity analysis). Enhanced specimen collection was conducted to salvage clinical respiratory swabs not tested for RSV during routine care. Data were analyzed from May to September 2024.ExposureRSVpreF vaccine receipt during the first RSV season after licensure and 21 or more days before LRTD event.Main outcomes and measuresEstimated VE against first episode of RSV-related LRTD hospitalization or ED visit.ResultsA total of 7047 LRTD-related hospitalizations or ED encounters with RSV testing results were included. The mean (SD) age was 76.8 (9.6) years; 3819 (54.2%) were female; 839 (11.9%) were non-Hispanic Asian or Pacific Islander, 2323 (33.0%) were Hispanic, 1197 (17.0%) were non-Hispanic Black, and 2602 (36.9%) were non-Hispanic White; 998 (14.2%) were immunocompromised; and 6573 (93.3%) had 1 or more Charlson comorbidity. Using strict controls, estimated adjusted VE was 91% (95% CI, 59%-98%). Using broad controls, estimated adjusted VE was 90% (95% CI, 59%-97%).Conclusions and RelevanceIn a high-risk, general population, RSVpreF vaccination conferred protection against RSV-related LRTD in the hospital and ED settings among US adults aged 60 years or older, the majority of whom were aged 75 years or older and had comorbidities. These data support use of this vaccine in older adults.

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Estimated Vaccine Effectiveness for Respiratory Syncytial Virus–Related Lower Respiratory Tract Disease

Tartof,

Aliabadi,

Goodwin

et al. 2024

JAMA Netw Open

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RSV Risk Profile in Hospitalized Adults and Comparison with Influenza and COVID-19 Controls in Valladolid, Spain, 2010–2022

Haeberer,

Mengel,

Fan

et al. 2024

Infect Dis Ther

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Introduction We aimed to describe the risk profile of respiratory syncytial virus (RSV) infections among adults ≥ 60 years in Valladolid from January 2010 to August 2022, and to compare them with influenza and COVID-19 controls. Methods This was a retrospective cohort study of all laboratory-confirmed RSV infections identified in centralized microbiology database during a 12-year period. We analyzed risk factors for RSV hospitalization and severity (length of stay, intensive care unit admission, in-hospital death or readmission < 30 days) and compared severity between RSV patients vs. influenza and COVID-19 controls using multivariable logistic regression models. Results We included 706 RSV patients (635 inpatients and 71 outpatients), and 598 influenza and 60 COVID-19 hospitalized controls with comparable sociodemographic profile. Among RSV patients, 96 (15%) had a subtype identified: 56% A, 42% B, and 2% A + B. Eighty-one percent of RSV patients had cardiovascular conditions, 65% endocrine/metabolic, 46% chronic lung, and 43% immunocompromising conditions. Thirty-six percent were coinfected (vs. 21% influenza and 20% COVID-19; p = < .0001 and 0.01). Ninety-two percent had signs of lower respiratory infection (vs. 85% influenza and 72% COVID-19, p = < .0001) and 27% cardiovascular signs (vs. 20% influenza and 8% COVID-19, p = 0.0031 and 0.0009). Laboratory parameters of anemia, inflammation, and hypoxemia were highest in RSV. Among RSV, being a previous smoker (adjusted OR 2.81 [95% CI 1.01, 7.82]), coinfection (4.34 [2.02, 9.34]), and having cardiovascular (3.79 [2.17, 6.62]), neurologic (2.20 [1.09, 4.46]), or chronic lung (1.93 [1.11, 3.38]) diseases were risks for hospitalization. Being resident in care institutions (1.68 [1.09, 2.61]) or having a coinfection (1.91[1.36, 2.69]) were risks for higher severity, while RSV subtype was not associated with severity. Whereas RSV and influenza patients did not show differences in severity, RSV patients had 68% (38–84%) lower odds of experiencing any severe outcome compared to COVID-19. Conclusions RSV especially affects those with comorbidities, coinfections, and living in care institutions. RSV vaccination could have an important public health impact in this population. Supplementary Information The online version contains supplementary material available at 10.1007/s40121-024-01021-1.

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Respiratory syncytial virus infections in adults: a narrative review

Wildenbeest,

Lowe,

Standing

et al. 2024

The Lancet Respiratory Medicine

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Respiratory Syncytial Virus Sequelae Among Adults in High-Income Countries: A Systematic Literature Review and Meta-analysis

Cited by 4 publications

References 55 publications

Estimated Vaccine Effectiveness for Respiratory Syncytial Virus–Related Lower Respiratory Tract Disease

Estimated Vaccine Effectiveness for Respiratory Syncytial Virus–Related Lower Respiratory Tract Disease

RSV Risk Profile in Hospitalized Adults and Comparison with Influenza and COVID-19 Controls in Valladolid, Spain, 2010–2022

Respiratory syncytial virus infections in adults: a narrative review

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