Unveiling the spectrum of Respiratory Syncytial Virus disease in Adults: from Community to Hospital
Listed in
This article is not in any list yet, why not save it to one of your lists.Abstract
Background
Respiratory syncytial virus can cause severe disease in the older adult population. Three vaccines for RSV are currently market approved but the risk of RSV-hospitalization in (older) adults from a community level remains elusive. We aimed to estimate the risk of RSV-hospitalization and characterize the patients that end up in hospital.
Methods
We retrospectively analyzed records of adults aged ≥20 with RSV-infection between 2022-2024 in three hospitals in the Netherlands. These hospitals implemented routine RSV-testing using the GeneXpert CoV-2/Flu/RSV at Emergency Departments. Using population-based data in combination with the in-hospital data, we estimated the population risk of RSV-hospitalization. Additionally, hospital records were analyzed to characterize RSV-patients and their course of disease.
Results
We investigated 709 RSV cases of whom 503 (70.9%) were hospitalized. 526 patients were ≥60, and 183 were <60 years of age. The population risk of RSV-hospitalization ranged from 0.006-0.02% for patients aged 20-59 years and 0.04-0.24% for those ≥60. The highest risks were seen in older patients with congestive heart disease (0.14-5.0%) and COPD (0.17-1.76%). RSV caused clinically relevant infection in 88% of hospital visits. Underlying comorbidity was prevalent (88.5%) and exacerbation of underlying disease by RSV caused of 46.3% of RSV-related hospital admissions. ICU admittance was 11.2% and in-hospital mortality was 8.1%.
Conclusion
Generally, the risk of RSV-hospitalization from the community is low. Older age, but mainly comorbidities increased this risk. Exacerbation of underlying disease was the main reason for RSV-related hospitalization. This indicates that RSV vaccines should primarily target those with high risk comorbidities.
TAKE HOME MESSAGE
Generally, the risk of RSV-hospitalization from the community is low as observed in our study. Older age, but mainly comorbidities increased this risk. This indicates that RSV vaccines should primarily target those with high risk comorbidities.
