IDWeek 2023: Social Determinants of RSV Hospitalization in Older Adults

This article is part of our IDWeek 2023 coverage. You can find all of our news here.

In a cohort of adults hospitalized for acute respiratory infection (ARI), those diagnosed with respiratory syncytial virus (RSV) were more likely to be women, be immunocompromised, and to have traveled within the prior 2 weeks, according to findings of a study presented during a poster session at IDWeek 2023, in Boston MA, October 11-15.

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RSV is common among older adults but investigators from Emory University School of Medicine point out that little is known about the social risk factors associated with hospitalization in this vulnerable population.

The team enrolled patients aged 50 years and older admitted with ARI or an exacerbation of congestive heart failure (CHF) or chronic obstructive pulmonary disease (COPD) to 2 Emory University hospitals between October 2018 and March 2020.

Participants provided medical and social history and additional details were retrieved from their medical charts. Standard-of-care specimens in addition to nasopharyngeal and oropharyngeal swabs were obtained and analyzed via multiplex polymerase chain reaction (PCR) test.

The Emory team compared demographics, interview responses, and selected comorbidities using bivariate analysis and generated a stepwise logistic regression model with inclusion in the model set at 0.05.

RESULTS

A total of 1429 patients were enrolled and 78 (5.5%) of them tested positive for RSV. When investigators compared this group to those who tested negative for RSV they found the infected group were more likely to be women (66.7% vs 55.3%, P = .05), to be immunocompromised (43.6% vs 31.5%, P = .03) and particularly with HIV/AIDS (11.5% vs 3.5%, P = .003). Patients infected with RSV also had more commonly traveled more than 100miles during the 2 weeks before hospitalization (12.8% vs. 6.7%, P = .04).

Analysis of baseline health status or other comorbidities found no significant differences between the groups, according to the study abstract. Compared with participants who tested negative for RSV, more of those who tested positive reported low to moderate levels of physical activity at baseline.

Comparing other participant characteristics between the groups with and without RSV, investigators observed no significant differences for those living with children or performing childcare more than 6 hours a week. In analyses adjusted for sex, activity frequency, travel, and immunocompromised status, men (OR 1.9, 95%CI 1.16-3.15), those who exercised 2-3 times per week (OR 2.3, 95%CI 1.26-4.38), who traveled (OR 2.3, 95%CI 1.09-4.70), or were immunocompromised (OR 1.8, 95%CI 1.10-2.85) had greater odds of RSV positivity compared to the reference groups.

The Emory research team commented that better understanding of risk factors for RSV infection requiring hospitalization may help in development of recommendations for disease prevention.

Source: De Castro K, Tippett A, Hussaini L, et al. Social risk factors for RSV-related hospitalizations in adults ≥ 50 years of age. Poster presented at IDWeek 2023; October 11-15, 2023; Boston, MA.