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MMWR Morb Mortal Wkly Rep . Disease Severity of Respiratory Syncytial Virus Compared with COVID-19 and Influenza Among Hospitalized Adults Aged ≥60

tetano

Editor, Senior Moderator
MMWR Morb Mortal Wkly Rep


. 2023 Oct 6;72(40):1083-1088.
doi: 10.15585/mmwr.mm7240a2.
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 Peltan, Samuel 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; IVY Network
Free article 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.


 
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