scholarly journals Hospitalizations for Respiratory Syncytial Virus Among Adults in the United States, 1997–2012

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
Susan T. Pastula ◽  
Judith Hackett ◽  
Jenna Coalson ◽  
Xiaohui Jiang ◽  
Tonya Villafana ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Syncytial Virus ◽  
The United States ◽  
Teaching Hospitals ◽  
Inpatient Mortality ◽  
Admission Rates ◽  
Hospitalization Rates ◽  
Syncytial Virus ◽  
Lower Respiratory Disease ◽  
Mean Cost

Abstract Background Respiratory syncytial virus (RSV) is an established cause of serious lower respiratory disease in children, but the burden in adults is less well studied. Methods We conducted a retrospective study of hospitalizations among adults ≥20 years from the 1997–2012 National Inpatient Sample. Trends in RSV admissions were described relative to unspecified viral pneumonia admissions. Hospitalization severity indicators were compared among immunocompromised RSV, non-immunocompromised RSV, and influenza admissions. Results An estimated 28237 adult RSV hospitalizations occurred, compared with 652818 influenza hospitalizations; 34% were immunocompromised individuals. Respiratory syncytial virus and influenza patients had similar age, gender, and race distributions, but RSV was more often diagnosed in urban teaching hospitals (73.0% for RSV vs 34.6% for influenza) and large hospitals (71.9% vs 56.4%). Respiratory syncytial virus hospitalization rates increased from 1997 to 2012, particularly for those ≥60, increasing from 0.5 to 4.6 per 100000, whereas unspecified pneumonia admission rates decreased significantly (P < .001). Immunocompromised patients with RSV hospitalization had significantly higher inpatient mortality (P = .013), use of mechanical ventilation (P = .016), mean length of stay (LOS) (P < .001), and mean cost (P < .001) than non-immunocompromised RSV hospitalizations. Overall, RSV hospitalizations were more severe than influenza hospitalizations (6.2% mortality for RSV vs 3.0% for influenza, 16.7% vs 7.2% mechanical ventilation, mean LOS of 6.0 vs 3.6 days, and mean cost of $38828 vs $14519). Conclusions Respiratory syncytial virus hospitalizations in adults are increasing, likely due to increasing recognition and diagnosis. The burden of RSV in adults deserves attention. Although there are fewer hospitalizations than influenza, those that are diagnosed are on average more severe.

scholarly journals 1719. Respiratory Syncytial Virus-Associated Hospitalization Rates among US Infants: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S843-S843
Author(s):  
John M McLaughlin ◽  
Farid L Khan ◽  
Heinz-Josef Schmitt ◽  
Yasmeen Agosti ◽  
Luis Jodar ◽  
...  
Keyword(s):  
Public Health ◽  
Respiratory Syncytial Virus ◽  
Active Surveillance ◽  
Meta Analysis ◽  
The United States ◽  
Administrative Claims ◽  
Prevention Strategies ◽  
Hospitalization Rates ◽  
Syncytial Virus ◽  
The Impact

Abstract Background Understanding the true magnitude of infant respiratory syncytial virus (RSV) burden is critical for determining the potential public-health benefit of RSV prevention strategies. Although global reviews of infant RSV burden exist, none have summarized data from the United States or evaluated how RSV burden estimates are influenced by variations in study design. Methods We performed a systematic literature review and meta-analysis of studies describing RSV-associated hospitalization rates among US infants. We also examined the impact of key study characteristics on these estimates. Results After review of 3058 articles through January 2020, we identified 25 studies with 31 unique estimates of RSV-associated hospitalization rates. Among US infants < 1 year of age, annual rates ranged from 8.4 to 40.8 per 1000 with a pooled rate= 19.4 (95%CI= 17.9–20.9). Study type was associated with RSV hospitalization rates (P =.003), with active surveillance studies having pooled rates per 1000 (11.1; 95%CI: 9.8–12.3) that were half that of studies based on administrative claims (21.4; 95%CI: 19.5–23.3) or modeling approaches (23.2; 95%CI: 20.2–26.2). Conclusion Applying the pooled rates identified in our review to the 2020 US birth cohort suggests that 73,680 to 86,020 RSV-associated infant hospitalizations occur each year. To date, public-health officials have used conservative estimates from active surveillance as the basis for defining US infant RSV burden. The full range of RSV-associated hospitalization rates identified in our review better characterizes the true RSV burden in infants and can better inform future evaluations of RSV prevention strategies. Disclosures John M. McLaughlin, PhD, Pfizer (Employee, Shareholder) Farid L. Khan, MPH, Pfizer (Employee, Shareholder) Heinz-Josef Schmitt, MD, Pfizer (Employee, Shareholder) Yasmeen Agosti, MD, Pfizer (Employee, Shareholder) Luis Jodar, PhD, Pfizer (Employee, Shareholder) Eric Simões, MD, Pfizer (Consultant, Research Grant or Support) David L. Swerdlow, MD, Pfizer (Employee, Shareholder)

scholarly journals Influenza A and respiratory syncytial virus hospital burden in young children in East London

2007 ◽  
Vol 136 (8) ◽  
pp. 1046-1058 ◽  
Author(s):  
E. K. AJAYI-OBE ◽  
P. G. COEN ◽  
R. HANDA ◽  
K. HAWRAMI ◽  
C. AITKEN ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Clinical Diagnosis ◽  
Influenza A ◽  
Epidemiological Studies ◽  
Incidence Rates ◽  
Infection Rates ◽  
Admission Rates ◽  
Hospitalization Rates ◽  
Accident And Emergency ◽  
Syncytial Virus

SUMMARYEpidemiological studies have demonstrated high hospitalization rates attributable to influenza and RSV in children aged <24 months. We prospectively recruited 977 children, aged <6 years, presenting with influenza-like illnesses at a hospital during two winter seasons between 2002 and 2004. Nasopharyngeal aspirates were performed and sent for viral immunofluorescence and PCR. Influenza and respiratory syncytial virus (RSV) rates were stratified by age, in-patient/outpatient status and clinical diagnosis. The influenza A and RSV hospitalization incidence rates were 4 and 11/10 000 person-months respectively, whereas the accident and emergency (A&E) outpatient rates were both 32/10 000 person-months in those aged <6 years. The influenza A and RSV hospitalization rates were highest in children aged <24 months and <12 months (9·1 and 35·7/10 000 person-months) respectively. Infection rates were particularly high in those aged <6 months for both viruses. The age-specific influenza A and RSV A&E admission rates were highest in those aged >6 months and those aged <12 months, respectively (43 and 92·5/10 000 person-months, respectively). In conclusion, these high paediatric RSV and influenza incidence rates can be used to inform UK policy on childhood influenza immunization and subsequent RSV immunization in the future.

scholarly journals The 2014–2015 National Impact of the 2014 American Academy of Pediatrics Guidance for Respiratory Syncytial Virus Immunoprophylaxis on Preterm Infants Born in the United States

2017 ◽  
Vol 35 (02) ◽  
pp. 192-200 ◽  
Author(s):  
Amanda Kong ◽  
Leonard Krilov ◽  
Jaime Fergie ◽  
Mitchell Goldstein ◽  
David Diakun ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Preterm Infants ◽  
The United States ◽  
Full Term ◽  
First Year ◽  
Term Infants ◽  
Medical Claims ◽  
Hospitalization Rates ◽  
Before And After ◽  
Syncytial Virus

Objective This article aims to compare respiratory syncytial virus (RSV) immunoprophylaxis (IP) use and RSV hospitalization rates (RSVH) in preterm and full-term infants without chronic lung disease of prematurity or congenital heart disease before and after the recommendation against RSV IP use in preterm infants born at 29 to 34 weeks' gestational age (wGA). Study Design Infants in commercial and Medicaid claims databases were followed from birth through first year to assess RSV IP and RSVH, as a function of infant's age and wGA. RSV IP was based on pharmacy or outpatient medical claims for palivizumab. RSVH was based on inpatient medical claims with a diagnosis of RSV. Results Commercial and Medicaid infants 29 to 34 wGA represented 2.9 to 3.5% of all births. RSV IP use in infants 29 to 34 wGA decreased 62 to 95% (p < 0.01) in the 2014–2015 season relative to the 2013–2014 season. Compared with the 2013–2014 season, RSVH increased by 2.7-fold (p = 0.02) and 1.4-fold (p = 0.03) for infants aged <3 months and 29 to 34 wGA in the 2014–2015 season with commercial and Medicaid insurance, respectively. In the 2014–2015 season, RSVH for infants 29 to 34 wGA were two to seven times higher than full-term infants without high-risk conditions. Conclusion Following the 2014 RSV IP guidance change, RSV IP use declined and RSVH increased among infants born at 29 to 34 wGA and aged <3 months.

scholarly journals 1708. Impacts of age and season on rates of hospitalization for respiratory syncytial virus (RSV) in infants in the United States and their use of mechanical ventilation and charges

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S837-S837
Author(s):  
Donald S Shepard
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Syncytial Virus ◽  
Seasonal Pattern ◽  
The United States ◽  
Hospitalization Rate ◽  
Hospital Charges ◽  
Average Charge ◽  
Clinical Predictors ◽  
Data Set ◽  
Syncytial Virus

Abstract Background Respiratory Syncytial Virus (RSV) infection is the leading cause of hospitalization in infants below age 12 months and highest below age 6 months. Despite considerable evidence on the clinical predictors of RSV hospitalizations, little is known about their cost, its drivers and their relation to age and season. Methods We used the National Inpatient Sample to examine RSV inpatient admissions and their average charge from 2009 to 2011. This 3-year data set includes a large, nationally representative all-payer sample of 37,376 RSV admissions of infants in the US under age 12 months recorded by month. We calculated the rate per 1000 infants of RSV hospitalizations, the share receiving mechanical ventilation (MV), and the mean charge per admission (separated by use of MV) with 95% confidence intervals by age and season, excluding incomplete data. We adjusted charges to Jan 2020 based on the medical care Consumer Price Index. Results These data confirm that rates of hospitalization by age were highest for infants 1 month of chronological age (2.42 times the annualized average) and declined steadily thereafter. The percentage of hospitalizations with MV declined from months &lt; 1 to 4, with subsequent fluctuations (Fig 1). Charges exceeded the annual average only for infants aged &lt; 1 and 1 month (Fig 2). In 2020 prices, hospitalization charges per episode averaged $175,211 with MV vs. $17,313 without MV, totaling $1.51 billion annually for the birth cohort of 4.04 million infants ($374 per infant). As only 4.5% of hospitalizations had MV, those without MV comprised 67.5% of aggregate yearly charges. Admissions were highly seasonal, with the rate in the highest month (Feb) 341 times that in the lowest month (July). However, utilization of MV (Fig 3) tended to be lower in the RSV season but depended mostly on age. While average charges were higher outside the RSV season, their seasonal pattern was similar for admissions with and without MV. Fig. 1. Share of hospitalizations with RV (bars) vs. rate of RSV hospitalizations (line) by age Fig. 2. Charges (bars) vs. rate of RSV hospitalizations (line) by age Fig. 3. Utilization of MV (bars) vs RSV hospitalization rate (line) by season Conclusion RSV in infants under one year generate substantial hospital charges. While each of the small share of infants receiving MV is expensive, infants with MV are not the main driver of costs (Fig 4). Rather, the large number and share (94.5%) of hospitalizations without MV is the major determinant of aggregate charges (Fig 5). Fig. 4. Relation between use of mechanical ventilation (MV) [bars] and RSV hospitalization rate [lines] by season and age (in months) Fig. 5. Hospitalization charges (bars) vs RSV hospitalization rate (line) by season Disclosures Donald S. Shepard, PhD, Sanofi Pasteur (Grant/Research Support)

scholarly journals Considerations for a Respiratory Syncytial Virus Vaccine Targeting an Elderly Population

Vaccines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 624
Author(s):  
Laura M. Stephens ◽  
Steven M. Varga
Keyword(s):  
Respiratory Syncytial Virus ◽  
Disease Burden ◽  
Elderly Population ◽  
Vaccine Development ◽  
The Elderly ◽  
The United States ◽  
Susceptible Population ◽  
Age Related ◽  
Syncytial Virus ◽  
Tract Infections

Respiratory syncytial virus (RSV) is most commonly associated with acute lower respiratory tract infections in infants and children. However, RSV also causes a high disease burden in the elderly that is often under recognized. Adults >65 years of age account for an estimated 80,000 RSV-associated hospitalizations and 14,000 deaths in the United States annually. RSV infection in aged individuals can result in more severe disease symptoms including pneumonia and bronchiolitis. Given the large disease burden caused by RSV in the aged, this population remains an important target for vaccine development. Aging results in lowered immune responsiveness characterized by impairments in both innate and adaptive immunity. This immune senescence poses a challenge when developing a vaccine targeting elderly individuals. An RSV vaccine tailored towards an elderly population will need to maximize the immune response elicited in order to overcome age-related defects in the immune system. In this article, we review the hurdles that must be overcome to successfully develop an RSV vaccine for use in the elderly, and discuss the vaccine candidates currently being tested in this highly susceptible population.

Respiratory Syncytial Virus (RSV) Diseases

2022 ◽  
Author(s):  
Heinz-Josef Schmitt ◽  
Khrystyna Hrynkevych
Keyword(s):  
Respiratory Syncytial Virus ◽  
Rna Virus ◽  
Passive Immunization ◽  
Active Immunization ◽  
F Protein ◽  
Hospitalization Rates ◽  
Syncytial Virus ◽  
Repeated Infections ◽  
Long Acting ◽  
Underlying Diseases

The respiratory syncytial virus (RSV) is an RNA virus that causes annual ARI outbreaks during winter with mild URTI in the general population, but with severe LRTI particularly among young children (bronchiolitis), patients with underlying diseases and people >65 years of age. RSV does not induce a long-lasting protective immunity and repeated infections throughout life are the norm. Basically, all children have been infected by 2 years of age and of those hospitalized, >50% are <3 months and 75% are <6 months of age. The overall CFR is 1/500. For adults ≥65 years, RSV hospitalization rates are 90–250/105. There is no specific therapy, general preventive measures include general hygiene and isolation/separation of patients. A monoclonal anti-F-protein antibody is available for passive immunization of selected high-risk children. It requires monthly injections, comes at a high cost and has limited efficacy (50% against RSV hospitalization). Active immunization failed in the past, probably as the post-fusion conformation of the F-protein was used. Long-acting monoclonal antibodies (for infants) as well as stabilized pre-fusion F-protein vaccines (for immunization of pregnant women, children, older adults) produced on various platforms are in late stages of clinical development.

scholarly journals Determining the Seasonality of Respiratory Syncytial Virus in the United States: The Impact of Increased Molecular Testing

2017 ◽  
Vol 216 (3) ◽  
pp. 345-355 ◽  
Author(s):  
Claire M Midgley ◽  
Amber K Haynes ◽  
Jason L Baumgardner ◽  
Christina Chommanard ◽  
Sara W Demas ◽  
...  
Keyword(s):  
United States ◽  
Respiratory Syncytial Virus ◽  
The United States ◽  
Molecular Testing ◽  
Syncytial Virus ◽  
The Impact

scholarly journals Respiratory Syncytial Virus Prophylaxis in Special Populations: Is it Something Worth Considering in Cystic Fibrosis and Immunosuppression?

2011 ◽  
Vol 16 (2) ◽  
pp. 77-86
Author(s):  
William A. Prescott ◽  
David J. Hutchinson
Keyword(s):  
Respiratory Syncytial Virus ◽  
Cost Benefit ◽  
The United States ◽  
Randomized Controlled ◽  
Increased Risk ◽  
Rsv Infection ◽  
Syncytial Virus ◽  
The Cost ◽  
Infant Hospitalization ◽  
Infants And Young Children

ABSTRACT Respiratory syncytial virus (RSV) bronchiolitis is the leading cause of infant hospitalization in the United States. Prophylaxis with palivizumab is effective in reducing RSV hospitalizations in premature infants and in infants or children with chronic lung disease or congenital heart disease. Patients with CF or those who are immunocompromised may be at increased risk for RSV infection–related complications; hence, prophylaxis may prove beneficial to these populations. The extent of palivizumab use in the CF and immunocompromised populations is variable. Palivizumab appears to be safe and may be effective in infants and young children with CF and immunocompromise. However, well-designed, randomized, controlled trials published in peer-reviewed journals are lacking, and its routine use can therefore not be recommended at this time. If used in patients with CF or those who are immunocompromised, RSV prophylaxis should be restricted to peak outbreak months in order to optimize the cost benefit of palivizumab.

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