Respiratory syncytial virus-associated hospitalisation in adults with comorbidities in two European countries: a modelling study

Abstract

Abstract Background Individuals with comorbidities are at increased risk of severe RSV infection. We estimated RSV-associated respiratory tract infection (RTI) hospitalisation among adults aged 45 years and older with comorbidities in Denmark and Scotland. Methods By analysing national hospital and virological data, we estimated the annual average number and rate of RSV-associated hospitalisations by seven selected comorbidities and ages during 2010-2018. We estimated rate ratios (RRs) of RSV-associated hospitalisation and 95% uncertainty ranges in comorbid adults versus the overall populations. Results In Danish adults (≥45 years), annual RSV-RTI hospitalisation rates ranged from 3.1 per 1000 adults with asthma to 19.4 per 1000 adults with chronic kidney disease (CKD). In Scotland, the annual rate ranged from 2.4 per 1000 adults with chronic liver disease (CLD) to 9.0 per 1000 adults with chronic obstructive pulmonary disease (COPD). In both countries, we found 2-4-fold increased risk of RSV hospitalisation in adults with COPD, ischemic heart disease (IHD), stroke and diabetes, 1.5-3-fold increased risk in adults with asthma, and 3-7-fold for those with CKD. RSV hospitalisation rates among adults aged 45-64 years with COPD, asthma, IHD or CKD were higher compared with the overall population. Conclusion The findings of this study provide important evidence for identifying risk groups and assisting health authorities in RSV vaccination policymaking.