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Disease Severity of Respiratory Syncytial Virus Compared with COVID-19 and Influenza Among Hospitalized Adults Aged =60 Years - IVY Network, 20 US States, February 2022-May 2023 MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT Surie, D., Yuengling, K. A., DeCuir, J., Zhu, Y., Gaglani, M., Ginde, A. A., Talbot, H., Casey, J. D., Mohr, N. M., Ghamande, S., Gibbs, K. W., Files, C., Hager, D. N., Ali, H., Prekker, M. E., Gong, M. N., Mohamed, A., Johnson, N. J., Steingrub, J. S., Peltan, I. D., Brown, S. M., Leis, A. M., Khan, A., Hough, C. L., Bender, W. S., Duggal, A., Wilson, J. G., Qadir, N., Chang, S. Y., Mallow, C., Kwon, J. H., Exline, M. C., Lauring, A. S., Shapiro, N. I., Columbus, C., Vaughn, I. A., Ramesh, M., Safdar, B., Halasa, N., Chappell, J. D., Grijalva, C. G., Baughman, A., Rice, T. W., Womack, K. N., Han, J. H., Swan, S. A., Mukherjee, I., Lewis, N. M., Ellington, S., McMorrow, M. L., Martin, E. T., Self, W. H., IVY Network 2023; 72 (40): 1083-1088

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.

View details for Web of Science ID 001084585300001

View details for PubMedID 37796753

View details for PubMedCentralID PMC10564326