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. 2025 Dec;21(1):2479334.
doi: 10.1080/21645515.2025.2479334. Epub 2025 Mar 24.

Demographics and clinical burden of disease among RSV-hospitalized older adults in Italy: A retrospective cohort study

Anna Puggina  1 , Melania Dovizio  2 , Alexander Domnich  3 , Alen Marijam  4 , Chiara Veronesi  2 , Caterina Rizzo  5 , Marta Vicentini  1 , Luca Degli Esposti  2 , Giovanna Elisa Calabrò  6   7 , Maria João Fonseca  8
Affiliations

Demographics and clinical burden of disease among RSV-hospitalized older adults in Italy: A retrospective cohort study

Anna Puggina et al. Hum Vaccin Immunother. 2025 Dec.

Abstract

Respiratory syncytial virus (RSV) is a leading cause of acute respiratory infection and can lead to severe disease in older adults or those with comorbidities. This analysis aims to evaluate the demographic and clinical burden of RSV hospitalizations among older adults in Italy and inform potential preventative strategies. Adults aged ≥50 years with ≥1 hospitalization discharge diagnosis for RSV from 2010 to 2021 were included. Demographic characteristics before the first RSV hospitalization and clinical outcomes during this hospitalization and the 12 months following are described. Of the 243 patients, mean (SD) age was 73.7 (13.1) years, 40.7% were male, and the most common comorbidities were chronic obstructive pulmonary disease (37.9%), diabetes (21.8%), and heart failure (15.2%). Mean length of index hospitalization was 17.0 days, during which 9.1% of patients died. At index or during the 12-month follow-up, 5.8% had an intensive care unit admission, 61.3% were prescribed antibiotics, 8.2% had a stroke, and 3.3% had an acute myocardial infarction. During the 12-month follow-up, approximately, half of patients experienced worsening of preexisting comorbidities, with notable rates of re-hospitalization and mortality (44.4% and 29.6%). This study shows a high clinical burden of RSV among older adults in Italy, emphasizing a need for improved RSV surveillance, and may guide policymakers and healthcare providers in making informed recommendations for, and implementation of, RSV vaccination in Italy.

Keywords: Respiratory syncytial virus (RSV); burden of disease; high risk; hospitalizations; older adults.

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Conflict of interest statement

AP, AM and MV: employees of and hold financial equities in GSK; MD and CV: employees of CliCon S.r.l; LDE: no conflicts of interest to declare; AD: received consulting fees from CSL Seqirus and VIHTALI, and payment or honoraria from SD Biosensor and CSL Seqirus; CR: received payment or honoraria from AstraZeneca, GSK, MSD, CSL Seqirus, and Sanofi; GEC: received grants or contracts, consulting fees, and payment or honoraria from GSK; participated on a Data Safety Monitoring Board or Advisory Board for GSK; Director of VIHTALI, a spin-off of Università Cattolica del Sacro Cuore, Rome, Italy; MJF: employee of, holds financial equities in GSK and has received support for attending meetings and/or travel from GSK as an employee.

Figures

None
Graphical abstract
Figure 1.
Figure 1.
All-cause post-index hospitalization during the 12-month follow up.
Figure 2.
Figure 2.
Worsening of pre-existing comorbidities for RSV-hospitalized patients aged ≥50 years in Italy between 2010 and 2021, stratified by age.
Figure 3.
Figure 3.
Mortality among RSV-hospitalized patients aged ≥50 years in Italy between 2010 and 2021, stratified by age.
Figure 4.
Figure 4.
Mortality among RSV-hospitalized patients aged ≥60 years in Italy between 2010 and 2021, stratified by risk group, comorbidity, and immunocompromised status.
See this image and copyright information in PMC

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