RSV linked to severe morbidity, mortality among hospitalized older adults
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Respiratory syncytial virus was associated with high rates of pneumonia, ventilatory support and both short- and long-term mortality among hospitalized older adult patients, according to a study published in Clinical Infectious Diseases.
“In our previous publication of a related study, we reported that the burden of severe respiratory syncytial virus (RSV) disease among older adults is substantial, clinically underrecognized, and may be even more severe than that of influenza, with worse long-term outcomes,” Hung Fu Tseng, PhD, MPH, of the department of research and evaluation at Southern California Permanente Medical Group, told Healio.
“With the encouraging prospect of potential interventions to prevent and treat RSV on the horizon, there remain critical evidence gaps about the clinical burden of RSV,” Tseng said. “This information is necessary to increase clinical understanding among the older adult health care provider community, to support health economic analyses, and to inform policy deliberations and eventual recommendations on the rational use of forthcoming interventions.”
Tseng and colleagues assessed hospitalized adults aged 60 years or older who tested positive for RSV between Jan. 1, 2011, and June 30, 2015, and evaluated their demographics, comorbidities, complications and mortality.
The study showed that the most common respiratory symptoms in older adults hospitalized with RSV were cough, tachypnea and shortness of breath/difficulty breathing/dyspnea. Of these patients, 66% developed pneumonia, around 21% required ventilator support and 18% were admitted to the ICU.
“Of great consequence to patients, providers, and the health care system, we noted high proportions of patients requiring home health services or nursing facility placement upon hospital discharge, high levels of hospital readmission within 30 days of discharge, and substantial health care utilization (outpatient, ED, and hospital visits) in the 6 months following discharge from an RSV-associated hospitalization,” Tseng said.
The study also showed that mortality during hospitalization was 5.6%, whereas cumulative mortality within 30 days, 3 months, 6 months and 12 months of admission was 8.6%, 12.3%, 17.2% and 25.8%, respectively. Additionally, nearly one-third of older adults aged 75 years or older died within 1 year of an RSV-associated hospitalization, and approximately 43% of patients who reported congestive heart failure exacerbation in conjunction with their severe RSV infection died within 1 year of their RSV-associated hospitalization.
“Increased recognition of the substantial RSV disease burden in adults will be important in the evaluation and use of urgently needed interventions,” Tseng said. “With an aging U.S. population, the significant health and economic impacts of severe RSV infection among the older adult population will only grow and draw increasing attention.”
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