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. 2022 Sep-Oct;137(5):929-935.
doi: 10.1177/00333549211041545. Epub 2021 Sep 6.

Severe Clinical Outcomes Among Adults Hospitalized With Respiratory Syncytial Virus Infections, New York City, 2017-2019

Connor R Goldman  1 , William D Sieling  1 , Luis R Alba  1 , Raul A Silverio Francisco  1 , Celibell Y Vargas  1 , Angela E Barrett  1 , Matthew Phillips  2 , Lyn Finelli  2 , Lisa Saiman  1   3
Affiliations

Severe Clinical Outcomes Among Adults Hospitalized With Respiratory Syncytial Virus Infections, New York City, 2017-2019

Connor R Goldman et al. Public Health Rep. 2022 Sep-Oct.

Abstract

Objectives: Respiratory syncytial virus (RSV) causes substantial morbidity and mortality in older adults. We assessed severe clinical outcomes among hospitalized adults that were associated with RSV infections.

Methods: We performed a nested retrospective study in 3 New York City hospitals during 2 respiratory viral seasons, October 2017-April 2018 and October 2018-April 2019, to determine the proportion of patients with laboratory-confirmed RSV infection who experienced severe outcomes defined as intensive care unit (ICU) admission, mechanical ventilation, and/or death. We assessed factors associated with these severe outcomes and explored the effect of RSV-associated hospitalizations on changes in the living situations of surviving patients.

Results: Of the 403 patients studied (median age, 69 years), 119 (29.5%) were aged ≥80. Severe outcomes occurred in 19.1% of patients, including ICU admissions (16.4%), mechanical ventilation (12.4%), and/or death (6.7%). Patients admitted from residential living facilities had a 4.43 times higher likelihood of severe RSV infection compared with patients who were living in the community with or without assistance from family or home health aides. At discharge, 56 (15.1%) patients required a higher level of care than at admission.

Conclusions: RSV infection was associated with severe outcomes in adults. Living in a residential facility at admission was a risk factor for severe outcomes and could be a proxy for frailty rather than an independent risk factor. Our data support the development of prevention strategies for RSV infection in older populations, especially older adults living in residential living facilities.

Keywords: assisted-living facilities; epidemiology; frailty; in-hospital mortality; respiratory syncytial virus.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: M.P. and L.F. are employees of Merck Sharp & Dohme Corp, a subsidiary of Merck & Co, Inc, Kenilworth, NJ, USA. L.S. has received research funding from and served on an advisory board for Merck Sharp & Dohme Corp.

Figures

Figure
Figure
Adults hospitalized with laboratory-confirmed respiratory syncytial virus infection, with and without severe clinical outcomes (intensive care unit admission, mechanical ventilation, and/or death), by admission month and year, October 2017 through April 2018 and October 2018 through April 2019, New York City. Data were extracted by the research team from the electronic medical records of 3 academically affiliated hospitals in northern Manhattan.
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