Characteristics of Patients Clinically Diagnosed with Respiratory Syncytial Virus Infection in the United States: a Retrospective Database Analysis. (4th October 2017)

• Record Type: Journal Article
• Authors: Wyffels, Veronique; Smulders, Maartje; Gavart, Sandra; Fleischhackl, Roman; Kanakamedala, Hemanth; Mazumder, Debasish; Gupta, Nikhil; Nguyen-Van-Tam, Jonathan
• Is Part Of: Open forum infectious diseases. Volume 4(2017)Supplement 1
• Page Start: S581
• Page End: S581
• Publication Date: 2017-10-04
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofx163.1519
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Respiratory syncytial virus (RSV) is recognized as a major respiratory pathogen in infants and young children. Its role in adults and elderly patients is less well characterized. We compare the comorbid characteristics and RSV hospitalization rate of infants and young children, and elderly patients clinically diagnosed with RSV in a large clinical database. Methods: Using de-identified Optum Integrated claims and electronic medical records, we included patients with first RSV infection (ICD-9 diagnosis codes 480.1/079.6/466.11 and ICD-10 codes J12.2/B97.4/J21.0/J21.0/J20.5) from 1 January 2008 to 31March 2016 and RSV-associated hospitalizations. Descriptive statistics are reported, with comparisons made by Chi-squared tests. Results: We included 27, 213 patients with a first RSV infection diagnosis. 1, 718 (12.97%) were first diagnosed during hospital admission; 1, 719 (12.98%) during emergency room attendance; and 9, 809 (74.05%) in ambulatory or hospital outpatient settings. 21, 872 (80.37%) were infants and young children (0–5 years) whilst 1, 554 (5.71%) were elderly (≥65 years), of whom respectively 18.30% and 86.68% had comorbid conditions. Of all eligible hospitalizations in RSV infants and young children 20.55% included RSV diagnosis, vs. 8.31% in elderly. Among infants and young children with RSV, the RSV hospitalization rate was 11.97% overall, compared with 29.02% in RSV elderly ( P < 0.001). Among infants and young children with RSV, RSV hospitalization rate was 17.89% in those with pre-existing medical conditions and 10.64% in those without ( P < 0.001). In the elderly, these proportions were respectively: 32.00%, and 9.66% ( P < 0.001). Conclusion: Whilst most of RSV disease activity is recognized in infants and young children, the likelihood of subsequent RSV hospitalization appears greater in the elderly, and is likely to be associated with their higher levels of underlying comorbidities. These results confirm that RSV causes clinically significant disease in a large proportion of elderly subjects in whom it is currently recognized, particularly in those with comorbid illnesses. Improved RSV recognition coupled with targeted therapies are likely to be impactful. Disclosures: V. Wyffels, Janssen Pharmaceutica Beerse: Employee, Salary; M. Smulders, Janssen Pharmaceutica Beerse: Consultant, Research grant; S. Gavart, Janssen Pharmaceutica Beerse: Employee, Salary; R. Fleischhackl, Janssen: Employee, Salary; H. Kanakamedala, Janssen Pharmaceutica Beerse: Consultant, Research grant; D. Mazumder, Janssen Pharmaceutica Beerse: Consultant, Research grant; N. Gupta, Janssen Pharmaceutica Beerse: Consultant, Research grant; J. Nguyen-Van-Tam, Novavax: Consultant, Consulting fee prior to this research project, in June 2016