Disease Burden Estimates of Respiratory Syncytial Virus related Acute Respiratory Infections in Adults With Comorbidity: A systematic review and meta-analysis

RESCEU Investigators

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Abstract

BACKGROUND
Respiratory syncytial virus associated acute respiratory infection (RSV-ARI) constitutes a substantial disease burden in adults, especially in those with comorbidities. We aimed to identify all studies worldwide investigating the disease burden of RSV-ARI in adults with comorbidities.
METHODS
We estimated the community incidence, hospitalisation rate and in-hospital case fatality ratio (hCFR) of RSV-ARI in adults with comorbidities based on a systematic review of studies published between January 1996 and March 2020. We also investigated the strength of the association between RSV-ARI and any comorbidity in adults. Meta-analyses based on random effects model were carried out to generate the estimates.
RESULTS
Overall 20 studies were included. Comorbidities such as cystic fibrosis, chronic obstructive pulmonary disease, congestive heart failure, immunocompromised status and human immunodeficiency virus were reported. The annual incidence rate of RSV-ARI in adults with any comorbidity was 37.6 (95% confidence interval 20.1-70.3) per 1,000 persons per year in industrialised countries and the seasonal incidence rate was 28.4 (11.4-70.9) per 1,000 persons per season. The hCFR in industrialised countries was 11.7% (5.8-23.4). There were no studies in developing countries. There were insufficient data to generate the meta-estimate of hospitalisation rate. The likelihood of experiencing RSV-ARI was estimated to be 4.1 (odds ratio; 1.6-10.4) from studies using univariable analysis and 1.1 (0.6-1.8) from studies using multivariable analysis for those with any comorbidity compared to those without.
CONCLUSION
The disease burden of RSV-ARI among adults with comorbidity is substantial with limited data available, especially for developing countries; appropriate prevention and management strategies are needed to reduce this burden.
Original languageEnglish
JournalThe Journal of Infectious Diseases
Early online date15 Sep 2021
DOIs
Publication statusE-pub ahead of print - 15 Sep 2021

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