Respiratory syncytial virus (RSV) is a leading cause of acute respiratory tract infections among adults and is estimated to cause approximately 159,000 hospitalizations among adults aged 65 years and older in the U.S. each year. Estimates of hospitalization among adults with outpatient medically attended RSV (MA-RSV) infections are required to design interventional studies that aim to prevent hospitalization. Landi, et al. (2024) sought to assess absolute risk of 28-day, all-cause hospitalization following outpatient MA-RSV infections in adults.

In this cohort study, data from three different deidentified databases containing electronic health records (EHR) linked to closed claims data were analyzed separately across six RSV years (October 1, 2016, to September 30, 2022) in adults with commercial or government insurance. Data were analyzed from March 2023 to April 2024. The main outcome was all-cause 28-day hospitalization following outpatient MA-RSV infections among all adults and a high-risk subgroup (defined as age ≥65 years or with asthma, chronic obstructive pulmonary disease [COPD], or congestive heart failure [CHF]).

In this cohort study of 67,239 MA-RSV infections in adults, most occurred among females (62%-67%) and comorbidity prevalences were 20.0% to 30.5% for COPD, 14.6% to 24.4% for CHF, 14.6% to 24.4% for asthma; 14.0% to 54.5% of individuals were aged 65 years or older. The proportion hospitalized was 6.2% (95% CI, 5.3%-7.1%) in Optum, 6.0% (95% CI, 5.4% to 6.5%) in TriNetX, and 4.5% (95% CI, 4.3%-4.6%) in VNEHR. Among the high-risk subgroup, the proportion hospitalized was 7.6% (95% CI, 6.5%-8.9%) in Optum, 8.5% (95% CI, 7.6%-9.4%) in TriNetX, and 6.5% (95% CI, 6.2%-6.8%) in VNEHR.

In this cohort study of adults with outpatient MA-RSV infections from three large de-identified U.S. databases across six RSV seasons, approximately 1 in 20 adults experienced all-cause hospitalization within 28 days. The results of this study highlight the public health need for RSV prevention and treatment.

Reference: Landi SN, et al. Hospitalization Following Outpatient Diagnosis of Respiratory Syncytial Virus in Adults. JAMA Netw Open. 2024;7(11):e2446010. doi:10.1001/jamanetworkopen.2024.46010