What is RSV, and why it matters to older adults
What is RSV, and why it matters to older adults
Respiratory syncytial virus (RSV) is an RNA virus of the genus Orthopneumovirus, family Pneumoviridae, primarily spread via respiratory droplets when an infected person coughs or sneezes. Transmission can also occur when a person touches their face after having direct contact with a contaminated surface.1
RSV SEASON HAS PEAKED EARLIER IN RECENT YEARS3
Percentage of PCR Test Results Positive for RSV (2017 through 2023)3*
*Three-week centered moving averages of percentage of RSV-positive PCR test results nationally reported to NREVSS. The threshold for a seasonal epidemic was set at 3% RSV-positive PCR test results (not based on a moving average). Reporting to NREVSS is voluntary, and analysis is limited to laboratories that consistently report, which might not represent local and state circulation. Differences in testing across regions and changes in testing practices and diagnostics over time, including increased panel testing during the COVID-19 pandemic, could have affected the baseline percentage of positive test results and trends, and thus the onset, offset, and duration of epidemics. There is no standard method for characterizing seasonality; seasonal attributes vary depending on the method used.3
A COMMON MISCONCEPTION ABOUT RSV
Many think of RSV infection as a disease for infants and children. RSV causes approximately 100-500 deaths each year in children less than 5 years old; it also causes an estimated 14,000 deaths annually in adults aged 65 years and older.4,5
THE ECONOMIC IMPACT OF RSV
- Adults 65 years and older with RSV may have $12,030 to $23,194 in additional healthcare resources annually compared with those without RSV6†
Adjusted annual healthcare costs for adults with RSV vs matched controls6
‡P<0.0001 vs non-RSV controls. §P=0.0003 vs non-RSV controls. ‖P<0.0001 vs non-RSV controls.
Study design: A retrospective case-control study used patient data from Truven Health Marketscan® Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases to identify patients aged ≥1 year with an RSV diagnosis between August 31, 2012, and August 1, 2013. An RSV episode was defined by an RSV ICD-9-CM code as the principal diagnosis for inpatient admissions, or as the first or secondary diagnosis for outpatient visits, and was considered as first consultation >28 days following any previous consultation with the same diagnosis code.6
Patients with RSV were matched 1:1 to controls without RSV based on age, sex, region, health plan, and index date (n=11,432 in each group). Stratified analyses for healthcare resource use and costs were conducted by age group.6
†Adjusted annual healthcare costs among patients with RSV and matched controls during the follow-up period. Costs adjusted to 2014 U.S. dollars. Associated costs were computed for each resource category and included inpatient visit, ED visit, ambulatory visit, outpatient visit, and prescription medications. Multivariate linear regression models were used to adjust the total healthcare costs; covariates included gender, region, high-risk status, and history of RSV during the baseline period.6
ED=emergency department; ICD-9-CM=International Classification of Diseases, Ninth Revision, Clinical Modification; NREVSS=National Respiratory and Enteric Virus Surveillance System; PCR=polymerase chain reaction.
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References:
1. Increased interseasonal respiratory syncytial virus (RSV) activity in parts of the southern United States. Centers for Disease Control and Prevention. Accessed June 29, 2022. https://emergency.cdc.gov/han/2021/han00443.asp 2. RSV surveillance & research. Centers for Disease Control and Prevention. Accessed April 17, 2023. https://www.cdc.gov/rsv/research/index.html 3. Hamid S, Winn A, Parikh R, et al. Seasonality of respiratory syncytial virus — United States, 2017–2023. MMWR. 2023;72(14):355-361. doi:10.15585/mmwr.mm7214a1 4. Thompson WW, Shay DK, Weintraub E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA. 2003;289(2):179-186. doi:10.1001/jama.289.2.179 5. Falsey AR, Hennessey PA, Formica MA, Cox C, Walsh EE. Respiratory syncytial virus infection in elderly and high-risk adults. N Engl J Med. 2005;352(17):1749-1759. doi:10.1056/NEJMoa043951 6. Amand C, Tong S, Kieffer A, Kyaw MH. Healthcare resource use and economic burden attributable to respiratory syncytial virus in the United States: a claims database analysis. BMC Health Serv Res. 2018;18(1):294. doi:10.1186/s12913-018-3066-1
