RSV Risk Profile in Hospitalized Adults and Comparison with Influenza and COVID-19 Controls in Valladolid, Spain, 2010-2022.
Mariana Haeberer, Martin Mengel, Rong Fan, Marina Toquero-Asensio, Alejandro Martin-Toribio, Qing Liu, Yongzheng He, Sonal Uppal, Silvia Rojo-Rello, Marta Dom��nguez-Gil, Cristina Hern��n-Garc��a, Virginia Fern��ndez-Espinilla, Caihua Liang, Elizabeth Begier, Javier Castrodeza Sanz, Jos�� M Eiros, Ivan Sanz-Mu��oz
Author Information
Mariana Haeberer: Pfizer SLU, Av Europa 20B, 28108, Madrid, Spain. mariana.haeberer@pfizer.com. ORCID
Martin Mengel: Independent Consultant, Valencia, Spain.
Rong Fan: Pfizer Inc, Collegeville, USA.
Marina Toquero-Asensio: National Influenza Centre, Valladolid, Spain.
Alejandro Martin-Toribio: National Influenza Centre, Valladolid, Spain.
Qing Liu: Pfizer Inc, Collegeville, USA.
Yongzheng He: Pfizer Inc, Collegeville, USA.
Sonal Uppal: Pfizer Inc, Collegeville, USA.
Silvia Rojo-Rello: National Influenza Centre, Valladolid, Spain.
Marta Dom��nguez-Gil: National Influenza Centre, Valladolid, Spain.
Cristina Hern��n-Garc��a: National Influenza Centre, Valladolid, Spain.
Virginia Fern��ndez-Espinilla: National Influenza Centre, Valladolid, Spain.
Caihua Liang: Pfizer Inc, Collegeville, USA.
Elizabeth Begier: Pfizer Inc, Collegeville, USA.
Javier Castrodeza Sanz: National Influenza Centre, Valladolid, Spain.
Jos�� M Eiros: National Influenza Centre, Valladolid, Spain.
Ivan Sanz-Mu��oz: Instituto de Estudios de Ciencias de la Salud de Castilla y Le��n, ICSCYL, Soria, Spain.
INTRODUCTION: We aimed to describe the risk profile of respiratory syncytial virus (RSV) infections among adults���������60 years in Valladolid from January 2010 to August 2022, and to compare them with influenza and COVID-19 controls. METHODS: This was a retrospective cohort study of all laboratory-confirmed RSV infections identified in centralized microbiology database during a 12-year period. We analyzed risk factors for RSV hospitalization and severity (length of stay, intensive care unit admission, in-hospital death or readmission���<���30 days) and compared severity between RSV patients vs. influenza and COVID-19 controls using multivariable logistic regression models. RESULTS: We included 706 RSV patients (635 inpatients and 71 outpatients), and 598 influenza and 60 COVID-19 hospitalized controls with comparable sociodemographic profile. Among RSV patients, 96 (15%) had a subtype identified: 56% A, 42% B, and 2% A���+���B. Eighty-one percent of RSV patients had cardiovascular conditions, 65% endocrine/metabolic, 46% chronic lung, and 43% immunocompromising conditions. Thirty-six percent were coinfected (vs. 21% influenza and 20% COVID-19; p���=������<���.0001 and 0.01). Ninety-two percent had signs of lower respiratory infection (vs. 85% influenza and 72% COVID-19, p���=������<���.0001) and 27% cardiovascular signs (vs. 20% influenza and 8% COVID-19, p���=���0.0031 and 0.0009). Laboratory parameters of anemia, inflammation, and hypoxemia were highest in RSV. Among RSV, being a previous smoker (adjusted OR 2.81 [95% CI 1.01, 7.82]), coinfection (4.34 [2.02, 9.34]), and having cardiovascular (3.79 [2.17, 6.62]), neurologic (2.20 [1.09, 4.46]), or chronic lung (1.93 [1.11, 3.38]) diseases were risks for hospitalization. Being resident in care institutions (1.68 [1.09, 2.61]) or having a coinfection (1.91[1.36, 2.69]) were risks for higher severity, while RSV subtype was not associated with severity. Whereas RSV and influenza patients did not show differences in severity, RSV patients had 68% (38-84%) lower odds of experiencing any severe outcome compared to COVID-19. CONCLUSIONS: RSV especially affects those with comorbidities, coinfections, and living in care institutions. RSV vaccination could have an important public health impact in this population.
