RSV burden is likely underestimated in older adults, which is why prevention strategies, like vaccination, are crucial for this population.
RSV is underreported in adult patients because its symptoms are typically mild, and diagnostic confirmation is difficult without seeking laboratory testing. These obstacles have made the real-world burden of disease challenging to study.
Dominique Luyts, MPH, and colleagues conducted a prospective study spanning Europe and the United States to evaluate the burden of RSV acute respiratory infections in older adults residing in the community and in long-term care facilities. She discussed the findings of the study, which was published in Open Forum Infectious Diseases, with Physician’s Weekly.
PW: Why did you feel this topic needed exploration?
Luyts: There are limited prospective surveillance studies that provide incidence rate estimates for RSV in the older adult population. Most studies report on cases that have been medically attended, thus likely underestimating the true burden that RSV may cause. Even so, RSV is recognized as an important pathogen in adults because it is contagious and can lead to severe lower respiratory tract disease in patients with comorbidities, including those with underlying health conditions and in older adults. This study allows us to explore the magnitude of RSV disease burden and consider the importance of prevention strategies to help mitigate severe health outcomes among older adults.
What are the most important findings from your study?
Our prospective cohort study covering two RSV seasons found that RSV is an important cause of disease burden among older adults in community-dwelling and long-term care facilities (Figure). Physicians should be aware of the disease burden and those who are more severely impacted by complications so that they are well-informed and equipped to provide appropriate preventive care to their patients. The findings from this study cohort help to shed light on the overall burden and support the need for prevention strategies against RSV among older adults, such as vaccination.
How can these findings be incorporated into practice?
We know that older adults are at risk for respiratory diseases, including RSV, due to decreased immunity as adults age. In addition, increased age raises the likelihood of comorbidities, some of which can lead to increased susceptibility to respiratory infection, including RSV. Older adults living in the community and long-term care facility residents are prime candidates for adoptable RSV prevention strategies. Healthcare providers and physicians practicing in similar facilities can incorporate evidence-based findings from studies such as this one to inform appropriate care discussions and shared decisions to potentially help prevent disease and improve outcomes.
What still needs to be explored?
As new prevention strategies are developed to help protect older adults against the impact and severe consequences of RSV, it will be important to explore the longer-term disease burden impact, overall healthcare resource utilization costs, and health outcomes that are associated with RSV-specific prevention strategies.
Is there anything else you’d like to mention?
The disease burden for RSV is significant and not fully realized, and given study limitations, it’s important to continue the study of RSV’s burden in diverse populations and the healthcare system, as well as the impact that certain prevention strategies, such as vaccines, can make on these outcomes. Broader insight from diverse populations will help us understand disease impact and help inform future prevention strategies and interventions.
