Comprehensive Review Reveals Substantial Burden of Respiratory Syncytial Virus in Adults Worldwide

Respiratory syncytial virus (RSV) poses a significant health risk, particularly for older adults and those with underlying health conditions, according to a study published in The Journal of Infectious Diseases.

RSV is a leading cause of lower respiratory tract infections globally, and in 2015 alone, it was responsible for 336 000 hospitalizations and 14 000 in-hospital deaths among adults aged 65 and older. The severity of RSV outcomes is higher in adults with chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF), nearly doubling their risk of severe infection compared to healthy individuals.

“Primary studies of RSV occurrence in adults typically report estimates by country, area, or age group,” wrote Benjamin Doty, Bohn Epidemiology, LLC in Boston, MA, and coauthors. “Reviews that include data from multiple countries, areas, and age groups are needed to guide future observational studies on RSV incidence and vaccination strategies by, for example, identifying regions and subpopulations at most need for a vaccine,” they continued.

The researchers conducted a comprehensive global review to assess the incidence of RSV in adults, including community and medically attended populations. The review focused on observational studies published between 2000 and 2022, covering regions across the globe. The aim was to identify patterns of RSV infection, high-risk populations, and geographic areas most in need of vaccination strategies.

Significant RSV infection rates were found in older adults, particularly those aged 65 and above. In Belgium, the Netherlands, and the UK, the cumulative RSV incidence among adults over 60 ranged from 2.1% to 4.9% in recent RSV seasons. In India and Thailand, incidence rates were notably higher, with up to 1230 per 100 000 person-years in adults over 65. Medically attended populations, especially those with underlying conditions like COPD and CHF, experienced high RSV incidence, with hospitalizations reaching up to 1077 per 100 000 among U.S. adults aged 65 and older. Patients with hematologic malignancies are also at high risk of RSV disease, with a cumulative incidence of 2.4% to 21.6% across studies.

Globally, the review identified significant geographic gaps in RSV data, with the majority of studies coming from North America and Europe. More research is needed to understand the full scope of RSV burden in Africa, Asia, and other underrepresented regions. Additionally, data on RSV incidence in younger and healthier adult populations remains limited.

“In conclusion, observational studies in adult populations showed that RSV incidence increases with advancing age and among those with underlying high-risk conditions,” concluded the study authors.

Reference

Doty B, Ghaswalla P, Bohn RL, Stoszek SK, Panozzo CA. Incidence of RSV in adults: A comprehensive review of observational studies and critical gaps in information. J Infect Dis. Published online June 27, 2024. doi:10.1093/infdis/jiae314