Disease Burden Estimates of Respiratory Syncytial Virus related Acute Respiratory Infections in Adults With Comorbidity: A Systematic Review and Meta-Analysis
Ting Shi, Sophie Vennard, Francis Jasiewicz, Rory Brogden, Harish Nair, RESCEU Investigators, Harish Nair, Harry Campbell, Ting Shi, You Li, Peter Openshaw, Philippe Beutels, Louis Bont, Andrew J. Pollard, Eva Molero, Federico Martinón‐Torres, Terho Heikkinen, Adam Meijer, Thea Kølsen Fischer, Maarten van den Berge, Carlo Giaquinto, Michael E. Abram, Kena A. Swanson, Sonia Stoszek, Jean Yves Pirçon, Scott Gallichan, Clarisse Demont, Jeroen Aerssens, Arnaud Chéret, Gabriela Ispas, Paul Peeters, Brian Rosen, Robert Fuentes, Ann R. Falsey, Rafael Mikolajczyk, Larry Anderson
Abstract
BACKGROUND: Respiratory syncytial virus related acute respiratory infection (RSV-ARI) constitutes a substantial disease burden in adults with comorbidities. We aimed to identify all studies investigating the disease burden of RSV-ARI in this group. METHODS: We estimated the incidence, hospitalization rate, and in-hospital case fatality ratio (hCFR) of RSV-ARI in adults with comorbidities based on a systematic review of studies published between January 1996 and March 2020. We also investigated the association between RSV-ARI and any comorbidity in adults. Meta-analyses based on random effects model were carried out. RESULTS: Overall, 20 studies were included. The annual incidence rate of RSV-ARI in adults with any comorbidity was 37.6 (95% confidence interval [CI], 20.1-70.3) per 1000 persons per year in industrialized countries and the seasonal incidence rate was 28.4 (11.4-70.9) per 1000 persons per season. The hCFR in industrialized countries was 11.7% (5.8%-23.4%). There were no studies in developing countries. There were insufficient data to generate the meta-estimate of hospitalization rate. The likelihood of experiencing RSV-ARI for those with any comorbidity compared to those without was estimated to be 4.1 (odds ratio [OR], 1.6-10.4) and 1.1 (OR, 0.6-1.8) from studies using univariable and multivariable analysis respectively. CONCLUSION: The disease burden of RSV-ARI among adults with comorbidity is substantial with limited data available.