RSV-associated hospitalization in adults in the USA: burden, management
strategies and outcomes
Abstract
Background: The burden of respiratory syncytial virus (RSV) infection in
adults is of growing concern. This study was designed to quantify
disease burden, treatment approaches, and outcomes associated with RSV
infections in adult subpopulations, from pre-hospitalization to hospital
discharge. Methods: A retrospective chart analysis was conducted to
collect patient-case data from hospitalized US adults (aged
>18 years) with RSV infection during two RSV seasons.
Patients were categorized into risk groups: comorbid lung disease,
immunocompromised, older adults (aged ≥65 years), and other adults (aged
<65 years). Physicians reported diagnosis, treatment choices
including respiratory supportive therapy (oxygen and fluid
supplementation), and outcome variables using a standardized online case
form. Results: The majority (277/379; 73%) of patients presented to the
emergency room, with a mean age of 60 years. Once hospitalized, median
length of stay was 6.0 days (3.0-9.0), with disease severity having the
greatest impact on duration of stay. No significant between group
differences in rates of patients requiring management in intensive cares
unit were found (comorbid lung disease, 28%; immunocompromised, 36%;
older adult, 26%; and other adult, 23%). Overall, respiratory
supportive therapy was the most commonly used form of treatment.
Antibiotics were administered in over half of all risk groups (comorbid
lung disease, 61%; immunocompromised, 59%; older adult, 59%; and
other adult, 51%). Patients usually required follow-up visits following
discharge, with 10%-16% requiring skilled nursing care and
approximately 25% requiring assistance from a social worker.
Conclusion: RSV in adult subpopulations, irrespective of age, is a
significant burden to healthcare systems.