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J Infect . Burden of Respiratory Syncytial Virus infection in older adults hospitalised in England during 2023/24

tetano

Editor, Senior Moderator
J Infect


. 2025 Aug 6:106570.
doi: 10.1016/j.jinf.2025.106570. Online ahead of print. Burden of Respiratory Syncytial Virus infection in older adults hospitalised in England during 2023/24

Rebecca Symes[SUP] 1 [/SUP], Suzanne H Keddie[SUP] 2 [/SUP], Jemma Walker[SUP] 2 [/SUP], Tricia McKeever[SUP] 3 [/SUP], Shazaad Ahmad[SUP] 4 [/SUP], David Arnold[SUP] 5 [/SUP], Cariad M Evans[SUP] 6 [/SUP], Emanuela Pelosi[SUP] 7 [/SUP], Najib Rahman[SUP] 8 [/SUP], Elizabeth Sapey[SUP] 9 [/SUP], Maria Zambon[SUP] 2 [/SUP], Conall Watson[SUP] 2 [/SUP], Jamie Lopez Bernal[SUP] 2 [/SUP], Wei Shen Lim[SUP] 10 [/SUP]; HARISS network collaborators



Collaborators, Affiliations
Free article Abstract

Objectives: We aimed to describe the incidence, presentation and clinical outcomes of RSV-associated acute respiratory infection (ARI) in older adults using a new national Hospital-based ARI Sentinel Surveillance (HARISS) system in England, prior to RSV vaccine introduction.
Methods: Adults aged ≥65 years from seven hospitals admitted for ≥24hours with symptomatic ARI were included. We estimated the hospitalisation rate of RSV-associated ARI compared to influenza-associated ARI and assessed clinical outcomes using Poisson regression and mortality using Cox regression.
Results: This study included 2743 adults. During winter 2023/4 the hospitalisation rate for RSV-associated ARI was 58.3 per 100,000, compared to 114.6 per 100,000 for influenza-associated ARI. Hospitalisations increased with age. Exacerbation of chronic illness (lung disease, heart disease, frailty) was a common admission reason in RSV-associated ARI, with a combined incidence of 33.1 per 100,000. Most adults with RSV-associated ARI had at least one comorbidity (81%); a high proportion with immunosuppression (26%). Symptoms and clinical outcomes including mortality were similar between RSV- and influenza-associated ARI; 30-day mortality 10.6% vs 8.7% (adjusted hazard ratio 0.85,95% confidence interval 0.6-1.2).
Conclusions: In England, RSV infection is a common cause of hospitalisation in older adults. Symptoms and clinical outcomes, including mortality, are comparable to influenza.

Keywords: Respiratory Syncytial Virus; Respiratory Syncytial Virus Vaccine; aged; epidemiology; hospitalisation; respiratory tract infection; sentinel surveillance.

 
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