Abstract
INTRODUCTION: Respiratory syncytial virus (RSV) can cause severe outcomes in hospitalized older adults and those with underlying comorbidities, but little is known regarding such outcomes stratified by age and comorbidity status. This study aimed to describe the intensive care unit (ICU) stay and receipt of mechanical ventilation (MV) among adults with RSV-related hospitalizations by age and risk group. METHODS: A retrospective cohort study was conducted using Optum Market Clarity Database to identify RSV-related hospitalizations among adults aged ≥ 18 years. ICU admission, length of ICU stays, and MV use were summarized by age and risk group. Patients with at least one predefined underlying condition were defined as high-risk, while low-risk adults lacked any of these conditions. RESULTS: A total of 13,734 RSV-related hospitalizations were identified, including 11,838 unique patients. Of these, 10.2% were low-risk and 89.8% were high-risk. ICU admissions occurred in 31.2% of RSV-related hospitalizations (high-risk, 32.1%; low-risk, 22.6%). High-risk younger adults had higher percentage of ICU admissions (18-49 years, 31.1%; 50-59 years, 34.8%) than older adults at low-risk (60-74 years, 27.8%; ≥ 75 years, 21.6%). Mean length of ICU stay was 4.5 days (high-risk, 4.6 days; low-risk, 2.8 days). Younger adults at high-risk had longer ICU stays (18-49 years, 5.9 days; 50-59 years, 5.4 days) compared to older adults at low-risk (60-74 years, 4.2 days; ≥ 75 years, 1.8 days). MV was used in 6.2% of RSV-related hospitalizations (high-risk, 6.6%; low-risk, 2.6%). ICU stays for those receiving MV were more than twice as long as ICU stays overall (mean 10.6 days). CONCLUSIONS: During RSV-related hospitalizations, adults at high-risk experienced more critical care outcomes compared to low-risk adults. Within risk status, results were similar with increasing age. However, younger adults at high-risk had more severe outcomes compared to older adults without such comorbidities, highlighting the importance of disease prevention in this group.