Abstract
BACKGROUND: RSV incidence in adults is frequently underestimated due to non-specific symptomatology, limited standard-of-care testing, and lower test sensitivity compared to infants. We conducted a retrospective observational study to estimate RSV-attributable incidence of specific types of cardiorespiratory hospitalizations among adults in Germany between 2015 and 2019. METHODS: Information on hospitalizations and the number of people at risk of hospitalization (denominator) was gathered from a Statutory Health Insurance database. A quasi-Poisson regression model accounting for periodic and aperiodic time trends and virus activity was fitted to estimate the RSV-attributable incidence rate (IR) of four specific cardiovascular hospitalizations (arrhythmia, ischemic heart diseases, chronic heart failure exacerbations, and cerebrovascular diseases) and four specific respiratory hospitalizations (influenza/pneumonia, bronchitis/bronchiolitis, chronic lower respiratory tract diseases, and upper respiratory tract diseases). RESULTS: The estimated RSV-attributable IRs of hospitalizations generally increased with age. Among estimated cardiovascular hospitalizations in adults aged ≥ 60 years, arrhythmia and ischemic heart diseases accounted for the highest incidence of RSV-attributable events, followed by chronic heart failure exacerbation, with annual IR ranges of 157-260, 133-214, and 105-169 per 100,000 person-years, respectively. The most frequent RSV-attributable respiratory hospitalizations in adults aged ≥ 60 years were estimated for chronic lower respiratory tract diseases and bronchitis/bronchiolitis, with annual IR ranges of 103-168 and 77-122 per 100,000 person-years, respectively. CONCLUSIONS: RSV causes a considerable burden of respiratory and cardiovascular hospitalizations in adults in Germany, similar to other respiratory viruses (e.g., influenza and SARS-CoV-2). This highlights the need to implement effective prevention strategies, especially for older adults.