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. 2022 Apr 14;5(3):e556.
doi: 10.1002/hsr2.556. eCollection 2022 May.

RSV-associated hospitalization in adults in the USA: A retrospective chart review investigating burden, management strategies, and outcomes

Edward Walsh  1 , Nelson Lee  2 , Ian Sander  3 , Robert Stolper  4 , Jessica Zakar  4 , Veronique Wyffels  5 , David Myers  6 , Roman Fleischhackl  7
Affiliations

RSV-associated hospitalization in adults in the USA: A retrospective chart review investigating burden, management strategies, and outcomes

Edward Walsh et al. Health Sci Rep. .

Abstract

Background and aims: 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 prehospitalization 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, the 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 care units were found (comorbid lung disease, 28%; immunocompromised, 36%; older adults, 26%; and other adults, 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 adults, 59%; and other adults, 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.

Keywords: adult; burden of disease; respiratory syncytial virus; retrospective.

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Conflict of interest statement

Nelson Lee has previously received honoraria for consultancy work, speaking in educational programs, and/or travel support from Shionogi Inc., Janssen, Sanofi Pasteur Ltd., F. Hoffmann‐La Roche Ltd., Genentech Inc., CIDARA Therapeutics Inc. Edward Walsh has research contracts from Gilead, Janssen, Merck Sharp & Dohme and unpaid consultation to Novavax, and Pfizer. Robert Stolper and Jessica Zakar are employees of IQVIA, a healthcare consulting firm engaged by Janssen Pharmaceuticals. Ian Sander is a former employee of IQVIA and a current employee of Ironwood Pharmaceuticals. Veronique Wyffels and Roman Fleischhackl are employees of Janssen Pharmaceuticals. David Myers is a former employee of Janssen Pharmaceuticals. Veronique Wyffels and Roman Fleischhackl may be Johnson & Johnson stockholders.

Figures

Figure 1
Figure 1
(A) Reasons for ICU admission, (B) ICU LOS (days) for RSV‐infected patients, and (C) proportion of patients with an ICU stay of 0–3 days or >3 days. Note: Patients could have multiple reasons for ICU admission. A cut‐off of 3 days was selected based on an overall median ICU LOS of 3.0 days. ICU, intensive care unit; LOS, length of stay; RSV, respiratory syncytial virus
Figure 2
Figure 2
Comparison of treatments used in (A) hospital and (B) in the ER by risk group and overall among patients with RSV infection. Note: “Supportive care” (as defined by the treating physician) was a specific option in the case form, and the option was nonexclusive. p values shown between population groups were significant; all other comparisons were not significant. ER, emergency room; RSV, respiratory syncytial virus
Figure 3
Figure 3
Treatment of RSV infection in hospital according to RSV infection severity. RSV, respiratory syncytial virus
Figure 4
Figure 4
(A) RSV‐infected patients with confirmed or suspected bacterial coinfection and (B) proportion of patients with reported antibiotic usage. Note: (B) adapted from Lee et al. RSV, respiratory syncytial virus
Figure 5
Figure 5
Comparison of types of follow‐up care posthospitalization required by RSV‐infected patients by risk group. RSV, respiratory syncytial virus
See this image and copyright information in PMC

References

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