A Higher Level of Care at Discharge Often Necessary After Health Care-Associated RSV

Health care-associated (HA) respiratory syncytial virus (RSV) in hospitalized adults was associated with requiring respiratory support escalation and a higher level of care at discharge, according to a study published in Infection Control & Hospital Epidemiology.

“These outcomes,” researchers wrote, “increase the use of health care resources and related costs.”

The retrospective cohort study included 84 patients with HA-RSV matched for age, sex, and respiratory season with 160 patients with community-onset (CO) RSV. The patients were hospitalized between October 2017 and March 2020 at two academically affiliated medical centers in the state of New York.

Patients with HA-RSV were no more likely than patients with CO-RSV to be admitted to an intensive care unit (ICU) or require mechanical ventilation, according to the study. However, 44% of those with HA-RSV required an increased level of support in their living situation at discharge compared with their living situation at admission. Among patients with CO-RSV, just 14% required more support at discharge.

The study also found that 22 of 77 evaluable patients with HA-RSV required an escalation of respiratory support from their baseline. They were significantly older than patients not requiring escalation (researchers reported a median age of 73 years vs 62 years), and 50% had respiratory comorbidities. They were also more likely to have been admitted to an ICU, to have had a longer length of stay following RSV detection, and to have died during hospitalization.

“Although this study cannot determine the mortality rate associated with HA-RSV, available data, such as death certificates and ICD-10 codes, likely underestimate this outcome,” researchers wrote. “Infection control and prevention and RSV vaccines for adults at high risk of HA-RSV could mitigate this risk.”

Reference: 
Hill-Ricciuti A, Walsh EE, Greendyke WG, et al. Clinical impact of healthcare-associated respiratory syncytial virus in hospitalized adults. Infect Control Hosp Epidemiol. 2023;44(3):433-439. doi:10.1017/ice.2022.128