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Burden of Respiratory syncytial virus (RSV) infection among adults in nursing and care homes: a systematic review
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  • Richard Osei-Yeboah,
  • Stephen Amankwah,
  • Elizabeth Begier,
  • Miranda Adedze,
  • Franklin Nyanzu,
  • Pious Appiah,
  • Jochebed Ode Boakye Ansah,
  • Harry Campbell,
  • Reiko Sato,
  • Luis Jodar,
  • Bradford D. Gessner,
  • Harish Nair
Richard Osei-Yeboah
The University of Edinburgh Centre for Global Health Research

Corresponding Author:richard.osei-yeboah@ed.ac.uk

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Stephen Amankwah
Instytut Biochemii i Biofizyki Polskiej Akademii Nauk Polska Stacja Antarktyczna im Henryka Arctowskiego
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Elizabeth Begier
Pfizer Global Research and Development Richmond
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Miranda Adedze
Goteborgs universitet Sahlgrenska Akademin
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Franklin Nyanzu
University of Ghana School of Public Health
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Pious Appiah
University of Ghana College of Health Sciences
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Jochebed Ode Boakye Ansah
The University of Toledo
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Harry Campbell
The University of Edinburgh Centre for Global Health Research
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Reiko Sato
Pfizer Durham
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Luis Jodar
Pfizer Global Research and Development
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Bradford D. Gessner
Pfizer Global Research and Development
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Harish Nair
The University of Edinburgh Centre for Global Health Research
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Abstract

Background Older adults in nursing and care homes (NCHs) are vulnerable to severe respiratory syncytial virus (RSV) infection, hospitalisation, and death. This study aimed to gather data on RSV disease among older adults in NCHs and identify reported risk factors for RSV hospitalisation and case fatality. Methods The study protocol was registered in PROSPERO (CRD42022371908). We searched MEDLINE, EMBASE and Global Health databases to identify articles published between 2000 and 2023. Observational and experimental studies conducted among older adults in NCHs requiring assistive care and reporting RSV illness were included and relevant data were extracted. Results Of 18,690 studies screened, 32 were selected for full-text review and 20 were included. Overall, the number of NCH residents ranged from 42 to 1,459 with a mean age between 67.6 and 85 years. Attack rates ranged from 6.7 – 47.6% and annual incidence ranged from 0.5 – 14%. Case fatality rates ranged from 7.7 – 23.1%. We found similar annual incidence rates of RSV-positive acute respiratory infection (ARI) of 4,582 (95% CI: 3,259 – 6,264) and 4,785 (95% CI: 2,258 – 10,141) per 100,000 reported in two studies. Annual incidence rate of RSV-positive lower respiratory tract infection was 3,040 (95% CI: 1,986 – 4,454) cases per 100,000 adults. Annual RSV-ARI hospital admission rates were between 600 (95% CI: 190 -10,000) and 1,104 (95% CI: 350 – 1,930) per 100,000 person-years. Among all RSV disease cases, commonly reported chronic medical conditions included chronic obstructive pulmonary disease (COPD), heart failure, ischemic heart disease, coronary artery disease, hypertension, diabetes, kidney dysfunction, cerebrovascular accident, malignancies, dementia, and those with a Charlson comorbidity score > 6.5. Conclusion Data on RSV infection among NCH residents are limited and largely heterogeneous but document a high risk of illness, frequent hospitalisation, and high mortality. Preventive interventions, such as vaccination should be considered for this high-risk population. Nationally representative epidemiologic studies and NCH-based viral pathogen surveillance could more precisely assess the burden on NCH residents.
18 Apr 2024Submitted to Influenza and other respiratory viruses
18 Apr 2024Submission Checks Completed
18 Apr 2024Assigned to Editor
19 May 2024Reviewer(s) Assigned
10 Jul 2024Review(s) Completed, Editorial Evaluation Pending
11 Aug 2024Editorial Decision: Revise Minor
19 Aug 20241st Revision Received
21 Aug 2024Submission Checks Completed
21 Aug 2024Assigned to Editor
29 Aug 2024Editorial Decision: Accept