United States: A new study has provided insights into the absolute risk of 28-day all-cause hospitalization among adults following outpatient medically attended respiratory syncytial virus (MA-RSV) infections. The research, which analyzed RSV cases during six RSV seasons from 2016 to 2022, highlights the substantial impact of RSV on adult populations, particularly those at high risk due to conditions like asthma, chronic obstructive pulmonary disease (COPD), congestive heart failure, or advanced age.
RSV is a leading cause of acute respiratory infections in adults, especially among individuals aged 65 and older. It is estimated to account for approximately 159,000 hospitalizations annually in this age group. Previous studies have attributed 82 percent to 90 percent of adult RSV-related hospitalizations within 28 to 30 days of diagnosis to acute respiratory infections.
Study Overview
The retrospective cohort study used de-identified data from three major databases—Optum, TriNetX, and Veradigm—spanning 2016 to 2022, encompassing 67,239 adult RSV cases diagnosed in outpatient settings. The data analysis included only closed insurance claims, ensuring a more complete patient follow-up. Of the total cases, females constituted the majority (62 percent to 67 percent).
The proportions of RSV-related hospitalizations varied slightly across the datasets:
Overall hospitalization rates:
– Optum: 6.2 percent
– TriNetX: 6.0 percent
– Veradigm: 4.5 percent
High-risk subgroup hospitalization rates:
– Optum: 7.6 percent
– TriNetX: 8.5 percent
– Veradigm: 6.5 percent
These findings indicate that approximately 1 in 20 adults with outpatient RSV infections required hospitalization within 28 days, with higher rates observed among high-risk individuals.
Implications and Challenges
The study underscores the unmet need for effective outpatient RSV treatments and preventive measures, such as vaccines or antiviral therapies, to reduce hospitalizations. Currently, RSV testing remains underutilized, potentially due to limited treatment options, but accurate testing can help identify RSV and avoid unnecessary treatments for other illnesses like COVID-19 or bacterial infections.
Dr. Joshua T. Swan of Pfizer emphasized that interventions to reduce hospitalizations could significantly benefit patients and the healthcare system. Similarly, Dr. Cameron Wolfe of Duke University Medical Center pointed out the diagnostic value of RSV testing in ruling out other illnesses, which aids in appropriate treatment decisions.
Conclusion
The findings highlight the significant burden of RSV-related hospitalizations, especially among high-risk adults, and point to a critical need for targeted interventions in outpatient settings. The development and adoption of new therapeutic and preventive strategies could substantially improve outcomes for those at risk.