USA: Adults with congestive heart failure (CHF) are at an 8-fold increased risk of respiratory syncytial virus (RSV)-associated hospitalization versus adults without CHF, reveals a recent study in PLOS One. Identification of populations at high risk for RSV infection can help inform future RSV vaccination policies and recommendations, the authors note.
Respiratory syncytial virus is a common cause of lower respiratory tract infection in infants and children and can also cause severe disease in older adults and adults with cardiopulmonary conditions, such as CHF. RSV infection has been linked with hospitalizations and deaths in adults with cardiopulmonary conditions. However, to date most studies have examined the association between RSV and cardiopulmonary conditions among older adult populations, and not much is known about risk across the adult age spectrum.
Against the above background, Stephanie A. Kujawski, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA, and colleagues aimed to quantify the rate of RSV-associated hospitalization in adults by CHF status using population-based surveillance in the United States.
For the purpose, the researchers performed population-based surveillance for RSV (RSV-NET) in 35 counties in seven sites during two respiratory seasons (2015–2017) from October 1–April 30. It included adults (≥18 years) admitted to a hospital within the surveillance catchment area with laboratory-confirmed RSV identified by clinician-directed testing. Medical chart abstraction was used to determine the presence of underlying CHF.
Overall and age-stratified (<65 years and ≥65 years) RSV-associated hospitalization rates was calculated by CHF status. Estimates were adjusted for age and the under-detection of RSV. Rate differences (RD) and rate ratios (RR) were also reported by comparing the rates for those with and without CHF.
Salient findings include:
2042 hospitalized RSV cases with CHF status recorded were identified. Most (60.2%, n = 1230) were ≥65 years, and 28.3% (n = 577) had CHF.
· The adjusted RSV hospitalization rate was 26.7 (95% CI: 22.2, 31.8) per 10,000 population in adults with CHF versus 3.3 per 10,000 in adults without CHF (RR: 8.1; RD: 23.4).
· Adults with CHF had higher rates of RSV-associated hospitalization in both age groups (<65 years and ≥65 years).
· Adults ≥65 years with CHF had the highest rate (40.5 per 10,000 population).
"We found high rates of RSV hospitalization in adults of all ages with CHF," wrote the authors. "RSV should be considered as a cause of acute respiratory illness and as a potential contributor to CHF exacerbations in adults during the respiratory season"
"There is requirement for more research on the rolls of RSV in acute exacerbations of CHF and the impact on long-term health outcomes. Understanding RSV importance in CHF patients can also inform future vaccine and treatment recommendations, they concluded.
Reference:
Kujawski SA, Whitaker M, Ritchey MD, Reingold AL, Chai SJ, Anderson EJ, et al. (2022) Rates of respiratory syncytial virus (RSV)-associated hospitalization among adults with congestive heart failure—United States, 2015–2017. PLoS ONE 17(3): e0264890. https://doi.org/10.1371/journal.pone.0264890
KEYWORDS: PLOS One, congestive heart failure, respiratory syncytial virus, hospitalization, CHF, Stephanie A Kujawski, exacerbations, cardiopulmonary conditions