Disease Severity of Respiratory Syncytial Virus Compared with COVID-19 and Influenza Among Hospitalized Adults Aged ≥60 Years — IVY Network, 20 U.S. States, February 2022–May 2023

Diya Surie, Katharine A. Yuengling, Jennifer DeCuir, Yuwei Zhu, Manjusha Gaglani, Adit A. Ginde, H. Keipp Talbot, Jonathan D. Casey, Nicholas M. Mohr, Shekhar Ghamande, Kevin W. Gibbs, D. Clark Files, David N. Hager, Harith Ali, Matthew E. Prekker, Michelle N. Gong, Amira Mohamed, Nicholas J. Johnson, Jay S. Steingrub, Ithan D. PeltanSamuel M. Brown, Aleda M. Leis, Akram Khan, Catherine L. Hough, William S. Bender, Abhijit Duggal, Jennifer G. Wilson, Nida Qadir, Steven Y. Chang, Christopher Mallow, Jennie H. Kwon, Matthew C. Exline, Adam S. Lauring, Nathan I. Shapiro, Cristie Columbus, Ivana A. Vaughn, Mayur Ramesh, Basmah Safdar, Natasha Halasa, James D. Chappell, Carlos G. Grijalva, Adrienne Baughman, Todd W. Rice, Kelsey N. Womack, Jin H. Han, Sydney A. Swan, Indrani Mukherjee, Nathaniel M. Lewis, Sascha Ellington, Meredith L. McMorrow, Emily T. Martin, Wesley H. Self

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

Abstract

On June 21, 2023, CDC's Advisory Committee on Immunization Practices recommended respiratory syncytial virus (RSV) vaccination for adults aged ≥60 years, offered to individual adults using shared clinical decision-making. Informed use of these vaccines requires an understanding of RSV disease severity. To characterize RSV-associated severity, 5,784 adults aged ≥60 years hospitalized with acute respiratory illness and laboratory-confirmed RSV, SARS-CoV-2, or influenza infection were prospectively enrolled from 25 hospitals in 20 U.S. states during February 1, 2022–May 31, 2023. Multivariable logistic regression was used to compare RSV disease severity with COVID-19 and influenza severity on the basis of the following outcomes: 1) standard flow (>30 L/minute) oxygen therapy, 2) high-flow nasal cannula (HFNC) or noninvasive ventilation (NIV), 3) intensive care unit (ICU) admission, and 4) invasive mechanical ventilation (IMV) or death. Overall, 304 (5.3%) enrolled adults were hospitalized with RSV, 4,734 (81.8%) with COVID-19 and 746 (12.9%) with influenza. Patients hospitalized with RSV were more likely to receive standard flow oxygen, HFNC or NIV, and ICU admission than were those hospitalized with COVID-19 or influenza. Patients hospitalized with RSV were more likely to receive IMV or die compared with patients hospitalized with influenza (adjusted odds ratio = 2.08; 95% CI = 1.33–3.26). Among hospitalized older adults, RSV was less common, but was associated with more severe disease than COVID-19 or influenza. High disease severity in older adults hospitalized with RSV is important to consider in shared clinical decision-making regarding RSV vaccination.

Original languageEnglish
Pages (from-to)1083-1088
Number of pages6
JournalMMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control
Volume72
Issue number40
DOIs
StatePublished - 2023

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