The health and economic burden of respiratory syncytial virus associated hospitalizations in adults

• Published in: PloS one Vol. 15; no. 6; p. e0234235
• Main Authors: Prasad, Namrata, Newbern, E Claire, Trenholme, Adrian A, Thompson, Mark G, McArthur, Colin, Wong, Conroy A, Jelley, Lauren, Aminisani, Nayyereh, Huang, Q Sue, Grant, Cameron C
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 11-06-2020; Public Library of Science (PLoS)
• Subjects: Adult; Adults; Age; Analysis; Biology and life sciences; Care and treatment; Confidence intervals; Cost of Illness; Diagnosis; Economic aspects; Economic impact; Economics; Female; Health care costs; Hospitalization - statistics & numerical data; Humans; Immunization; Infections; Laboratories; Male; Medicine and Health Sciences; Minority & ethnic groups; Older people; People and Places; Respiratory syncytial virus; Respiratory Syncytial Virus Infections - economics; Respiratory Syncytial Virus Infections - therapy; Retrospective Studies; Seasons; Socioeconomics; Studies; Vaccines; Viruses; New Zealand; United States > US
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0234235

Respiratory syncytial virus (RSV) is increasingly recognized as an important cause of illness in adults; however, data on RSV disease and economic burden in this age group remain limited. We aimed to provide comprehensive estimates of RSV disease burden among adults aged ≥18 years.
During 2012-2015, population-based, active surveillance of acute respiratory infection (ARI) hospitalizations enabled estimation of the seasonal incidence of RSV hospitalizations and direct health costs in adults aged ≥18 years in Auckland, New Zealand.
Of 4,600 ARI hospitalizations tested for RSV, 348 (7.6%) were RSV positive. The median (interquartile range) length of hospital stay for RSV positive patients was 4 (2-6) days. The seasonal incidence rate (IR) of RSV hospitalizations, corrected for non-testing, was 23.6 (95% confidence intervals [CI] 21.0-26.1) per 100,000 adults aged ≥18 years. Hospitalization risk increased with age with the highest incidence among adults aged ≥80 years (IR 190.8 per 100,000, 95% CI 137.6-244.0). Being of Māori or Pacific ethnicity or living in a neighborhood with low socioeconomic status (SES) were independently associated with increased RSV hospitalization rates. We estimate RSV-associated hospitalizations among adults aged ≥18 years to cost on average NZD $4,758 per event.
RSV infection is associated with considerable disease and economic cost in adults. RSV disproportionally affects adult sub-groups defined by age, ethnicity, and neighborhood SES. An effective RSV vaccine or RSV treatment may offer benefits for older adults.