Comparative incidence and burden of respiratory viruses associated with
hospitalization in adults in New York City
Abstract
Background: Although the burden of influenza is well characterized, the
burden of community-onset non-influenza respiratory viruses has not been
systematically assessed. Understanding the severity and seasonality of
non-influenza viruses, including human coronaviruses, will provide a
better understanding of the overall disease burden from respiratory
viruses that could better inform resource utilization for hospitals and
highlight the value of preventative strategies, including vaccines.
Methods: From October 2017 to September 2019, a retrospective study was
performed in a pre-defined catchment area to estimate the
population-based incidence of community-onset respiratory viruses
associated with hospitalization. Included patients were >18
years old, resided in New York City, were hospitalized for
>24 hours, and had a respiratory virus detected within 3
calendar-days of admission. Disease burden was measured by hospital
length of stay (LOS), intensive care unit (ICU) admissions, and
in-hospital mortality and compared among those with laboratory-confirmed
influenza versus those with laboratory-confirmed non-influenza viruses
(human coronaviruses, parainfluenza viruses, respiratory syncytial
virus, human metapneumovirus, and adenovirus). Results: During the study
period, 4,232 eligible patients were identified of whom 50.9% were
>65 years of age. For each virus, the population-based
incidence was highest for those >80 years of age. When
compared to those with influenza viruses detected, those with
non-influenza respiratory viruses detected (combined) had higher
population-based incidence, significantly more ICU admissions, and
higher in-house mortality. Conclusions: The burden of non-influenza
respiratory viruses for hospitalized adults is substantial. Prevention
and treatment strategies are needed for non-influenza respiratory
viruses, particularly for older adults.