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RSV-associated hospitalization in adults in the USA: burden, management strategies and outcomes
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  • Edward Walsh,
  • Nelson Lee,
  • Ian Sander,
  • Robert Stolper,
  • Jessica Zakar,
  • Veronique Wyffels,
  • David Myers,
  • Roman Fleischhackl
Edward Walsh
University of Rochester School of Medicine and Dentistry
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Nelson Lee
University of Alberta
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Ian Sander
IQVIA Consulting Services
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Robert Stolper
IQVIA Consulting Services
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Jessica Zakar
IQVIA Consulting Services
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Veronique Wyffels
Janssen-Cilag BV
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David Myers
Janssen Cilag AB
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Roman Fleischhackl
Janssen-Cilag Pharma GmbH

Corresponding Author:rfleisch@its.jnj.com

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Abstract

Background: The burden of respiratory syncytial virus (RSV) infection in adults is of growing concern. This study was designed to quantify disease burden, treatment approaches, and outcomes associated with RSV infections in adult subpopulations, from pre-hospitalization to hospital discharge. Methods: A retrospective chart analysis was conducted to collect patient-case data from hospitalized US adults (aged >18 years) with RSV infection during two RSV seasons. Patients were categorized into risk groups: comorbid lung disease, immunocompromised, older adults (aged ≥65 years), and other adults (aged <65 years). Physicians reported diagnosis, treatment choices including respiratory supportive therapy (oxygen and fluid supplementation), and outcome variables using a standardized online case form. Results: The majority (277/379; 73%) of patients presented to the emergency room, with a mean age of 60 years. Once hospitalized, median length of stay was 6.0 days (3.0-9.0), with disease severity having the greatest impact on duration of stay. No significant between group differences in rates of patients requiring management in intensive cares unit were found (comorbid lung disease, 28%; immunocompromised, 36%; older adult, 26%; and other adult, 23%). Overall, respiratory supportive therapy was the most commonly used form of treatment. Antibiotics were administered in over half of all risk groups (comorbid lung disease, 61%; immunocompromised, 59%; older adult, 59%; and other adult, 51%). Patients usually required follow-up visits following discharge, with 10%-16% requiring skilled nursing care and approximately 25% requiring assistance from a social worker. Conclusion: RSV in adult subpopulations, irrespective of age, is a significant burden to healthcare systems.