Burden of respiratory syncytial virus (RSV) disease in adults: final analysis from a retrospective chart review

Background: Data demonstrating the burden of RSV disease in adults are limited. This analysis aimed to quantify the burden of RSV infections in at-risk adult subpopulations. Methods: A retrospective review of patient charts (Oct 2014–Oct 2016; USA) was conducted. Data for adults ≥18 years with confirmed RSV diagnosis were collected. Each hospital physician submitted up to 3 randomly selected patient cases via an online survey. Results: This study comprised 379 patients, collected in 4 groups: underlying chronic lung disease (31%; Group A), immunocompromised (24%; Group B), elderly (≥65 years; 29%; Group C) (all RSV at-risk groups) and other adults without identified risk factors (16%; Group D). Baseline characteristics for Groups A–D, were respectively: median 64.0/56.5/70.0/40.5 years, male 56/57/55/57%, Caucasian 57/60/60/53%, asthma 21/8/6/12%, coronary artery disease 23/8/22/12%, and hypertension 27/8/26/12%. Mean length of hospital stay was 6.8–7.5 days by group, with 20–36% admitted to the intensive care unit (ICU) and 3–5% all-cause mortality within 60 days of hospitalization. Hospital respiratory support treatments for Groups A–D, were respectively: supplemental oxygen 74/76/77/73%, bronchodilators 68/68/65/62%, invasive/noninvasive mechanical ventilation 13/16/13/10%, and supportive care 8/6/11/7%. 48–60% received antibiotics (mean 4.5–5.8 days, 25% had confirmed bacterial coinfection). Other hospital treatments for Groups A–D included corticosteroids 57/39/43/42% and ribavirin 29/40/26/38%. Conclusion: Hospitalised adults with RSV place a large burden on healthcare resources, due in part to long hospital stays and ICU admission alongside concomitant treatments.