RSV more severe than COVID-19, flu in older adults, CDC data show
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Key takeaways:
- New data show that although there are far more COVID-19 and influenza hospitalizations, RSV caused more severe outcomes.
- For the first time, vaccines against all three respiratory diseases are available.
Fewer older adults are hospitalized with respiratory syncytial virus than COVID-19 or influenza, but those who are experience more serious outcomes than patients hospitalized with the other two illnesses, new CDC data show.
The data are from one of three studies published Thursday in MMWR that highlight the potential severity of RSV and COVID-19 among older adults in the United States and underscore the importance of getting vaccinated, the CDC said.
The other two studies include data showing that RSV hospitalizations are most common among adults aged older than 75 years, and that less than one-quarter of adults aged older than 65 years who were hospitalized with SARS-CoV-2 infection had received a recommended COVID-19 booster vaccine.
Last month, the National Foundation for Infectious Diseases reported findings from a survey that showed most adults in the U.S. are not concerned about COVID-19, influenza or RSV, despite ongoing worries about a fall “tripledemic.”
For the first time ever, vaccines are available for all three illnesses, including updated COVID-19 shots and the world’s first vaccines against RSV.
In one study published Thursday, Diya Surie, MD, from the CDC’s Coronavirus and Other Respiratory Viruses Division, and colleagues analyzed data on 5,784 adults aged older than 60 years enrolled by the CDC’s IVY Network who were hospitalized with lab-confirmed influenza, RSV or SARS-CoV-2 infection between Feb. 1, 2022, and May 31, 2023. Among patients included in the analysis, 81.8% had COVID-19, 12.9% had influenza and 5.3% had RSV.
The odds that a patient needed mechanical ventilation or died were similar between patients with RSV and patients with COVID-19 (adjusted OR = 1.39; 95% CI, 0.98-1.96), but were significantly higher for patients with RSV than for patients with influenza (aOR = 2.08; 95% CI, 1.33-3.26), according to the study.
“Because RSV disease is less common than COVID-19 or influenza disease among hospitalized patients, clinicians might be less aware of RSV as a serious respiratory pathogen in older adults,” Surie and colleagues wrote.
In another study, Fiona P. Havers, MD, a medical epidemiologist at the CDC, and colleagues assessed population-based surveillance data from the CDC’s RSV-NET on adults aged older than 60 years hospitalized with RSV between July 1, 2022, and June 30, 2023.
Among more than 3,200 hospitalized patients, 54% were adults aged older than 75 years, 37.5% were adults aged older than 80 years, and 13.5% were adults aged 60 to 64 years. Additionally, 17.2% of the patients lived in long-term care facilities, according to the study.
Havers and colleagues said clinicians and patients should consider age — especially older than 75 years — long-term care facility residence and underlying medical conditions when making decisions about vaccination.
A third study by Christopher A. Taylor, PhD, of the CDC’s National Center for Immunization and Respiratory Diseases, and colleagues analyzed population-based surveillance data on lab-confirmed COVID-19-associated hospitalizations from COVID-NET collected between January and August 2023.
They found that the rate of COVID-19 hospitalizations among adults aged older than 65 years decreased by 86% during the study period from 42.2 per 100,000 to 5.9 per 100,00 — its lowest level since July 2021 — before increasing again to 16.4 per 100,000 at the end of August 2021.
Among hospitalized patients, 62.9% were adults aged older than 65 years, most of whom had underlying conditions. Of these patients, just 23.5% had received a recommended COVID-19 bivalent vaccine.
“Adults with increased risk for COVID-19-associated hospitalization, including all adults aged 65 years and older, should reduce their risk for severe COVID-19 by receiving recommended COVID-19 vaccinations, adopting measures to reduce risk for contracting COVID-19 and seeking prompt outpatient antiviral treatment after a positive SARS-CoV-2 test,” Taylor and colleagues wrote.
References:
- Havers FP, et al. MMWR Morb Mortal Wkly Rep. 2023;doi:10.15585/mmwr.mm7240a1.
- Surie D, et al. MMWR Morb Mortal Wkly Rep. 2023;doi:10.15585/mmwr.mm7240a2.
- Taylor CA, et al. MMWR Morb Mortal Wkly Rep. 2023;doi:10.15585/mmwr.mm7240a3.
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