Respiratory syncytial virus (RSV) disease in hospitalised adults in Europe with COPD: Impact of GOLD score on RSV disease burden

Background: Adults with COPD are at risk of RSV infection, but the effect of severity of COPD on burden of RSV disease and treatment is not fully understood. This analysis describes the burden of adults by 2014 COPD GOLD score 1-2 (CG1-2) and 3-4 (CG3-4) hospitalised with RSV. Methods: A retrospective review of 399 patient charts including 105 COPD patients across European countries (France, UK, Germany, Austria, Switzerland) was conducted, collecting data for hospitalised adults ≥18 years with a test-confirmed RSV diagnosis. Each hospital physician submitted up to 3 randomly-selected patient cases from the 2 previous Northern Hemisphere RSV seasons (2014–16) via an online survey. Results: Baseline characteristics for CG1-2 (n=64)/CG3-4 patients (n=41), were respectively: median age 73/69 years; male 34/34%, heart disease 36/39%, diabetes 29/29%, immunocompromised 20/17%. Median hospital length of stay (LOS) was 11 days in CG1-2 patients and 9 days in CG3-4 patients. Intensive care unit (ICU) admission and invasive mechanical ventilation appeared higher in CG3-4 patients (39/7%, respectively) than CG1-2 patients (22/3%, respectively). Antibiotic use was higher in CG3-4 patients (68%) than CG1-2 patients (58%). The proportion of patients experiencing complications during hospitalisation was similar in CG1-2 patients (31%) compared with CG3-4 patients (37%). Conclusion: This real-life set of clinical data suggest burden of RSV is broad with a long hospital LOS across all COPD GOLD scores. However, there appears to be a correlation between COPD severity and RSV treatment burden (increased ICU admission and use of antibiotics).