Respiratory Syncytial Virus–Associated Hospitalizations Among Adults With Chronic Medical Conditions

Author:

Prasad Namrata12ORCID,Walker Tiffany A1,Waite Ben1,Wood Tim1,Trenholme Adrian A3,Baker Michael G4,McArthur Colin5,Wong Conroy A36,Grant Cameron C27,Huang Q Sue1,Newbern E Claire1

Affiliation:

1. National Centre for Biosecurity and Infectious Disease (NCBID), Institute of Environmental Science and Research, Wellington, New Zealand

2. Department of Paediatrics: Child & Youth Health, University of Auckland, Auckland, New Zealand

3. Kidz First Children’s Hospital, Counties Manukau District Health Board, Auckland, New Zealand

4. School of Medicine, University of Auckland, Auckland, New Zealand

5. School of Medicine, University of Otago, Wellington, New Zealand

6. Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand

7. General Paediatrics, Starship Children’s Hospital, Auckland, New Zealand

Abstract

Abstract Background In contrast with respiratory disease caused by influenza, information on the risk of respiratory syncytial virus (RSV) disease among adults with chronic medical conditions (CMCs) is limited. Methods We linked population-based surveillance of acute respiratory illness hospitalizations to national administrative data to estimate seasonal RSV hospitalization rates among adults aged 18–80 years with the following preexisting CMCs: chronic obstructive pulmonary disease (COPD), asthma, congestive heart failure (CHF), coronary artery disease (CAD), cerebrovascular accidents (CVA), diabetes mellitus (DM), and end-stage renal disease (ESRD). Age- and ethnicity-adjusted rates stratified by age group were estimated. Results Among 883 999 adult residents aged 18–80 years, 281 RSV-positive hospitalizations were detected during 2012–2015 winter seasons. Across all ages, RSV hospitalization rates were significantly higher among adults with COPD, asthma, CHF, and CAD compared with those without each corresponding condition. RSV hospitalization rates were significantly higher among adults with ESRD aged 50–64 years and adults with DM aged 18–49 years and 65–80 years compared with adults in each age group without these conditions. No increased risk was seen for adults with CVA. The CMC with the highest risk of RSV hospitalization was CHF (incidence rate ratio [IRR] range, 4.6–36.5 across age strata) and COPD (IRR range, 9.6–9.7). Among RSV-positive adults, CHF and COPD were independently associated with increased length of hospital stay. Conclusions Adults with specific CMCs are at increased risk of RSV hospitalizations. Age affects this relationship for some CMCs. Such populations maybe relevant for future RSV prevention strategies.

Funder

US Centers of Disease Control and Prevention

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

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