Issue: June 2020
Source/Disclosures
Disclosures: Ackerson reports receiving research support from Novavax for a related study and serving a member of the scientific advisory committee for the Bexsero and Menveo pregnancy registries. Please see the study for all other authors’ relevant financial disclosures.
May 09, 2020
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Hospitalization costs for RSV similar to influenza costs in older adults

Issue: June 2020
Source/Disclosures
Disclosures: Ackerson reports receiving research support from Novavax for a related study and serving a member of the scientific advisory committee for the Bexsero and Menveo pregnancy registries. Please see the study for all other authors’ relevant financial disclosures.
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Older adults hospitalized with respiratory syncytial virus face costs that are similar to those of older adults hospitalized with influenza, according to findings published in The Journal of Infectious Diseases.

“There is an underappreciation of the burden of respiratory syncytial virus (RSV) disease in older adults. We felt that comparing the cost of hospitalization of older adults associated with RSV vs. the cost of hospitalization of older adults associated with influenza, a well-recognized cause of severe disease in older adults, would help increase awareness among adult providers of the burden of RSV disease,” Bradley Ackerson, MD, of the pediatric infectious diseases division at Kaiser Permanente Southern California South Bay Medical Center, told Healio.

Ackerson and colleagues compared the costs for 2,090 adults aged 60 years and older who were hospitalized with RSV or influenza by assigning nationally recognized direct health care costs to each hospitalization in an observational, retrospective study at Kaiser Permanente Southern California.

According to Ackerson, the study demonstrated that hospitalization with RSV was associated with longer hospitalization and increased pulmonary complications, resulting in costs at least as great as those for influenza.

The study included 579 patients who were hospitalized with RSV and 1,511 patients were hospitalized with influenza. In the RSV cohort, the infection was detected within 3 days in 96.7% of people and within 1 week of admission in 99.4% of patients. In the influenza cohort, the illness was detected in 97.3% of patients within 3 days and in 99.1% of patients within 1 week of admission.

Patients hospitalized with RSV were similar in age to those with influenza (mean age, 78.4 vs. 77.7 years) but more likely to be female (58.5% vs. 50.4%; P < .001). Patients with RSV had diabetes less often (39.4% vs. 45.1%; P = .018) but more often had a history of congestive heart failure (40.6% vs. 27.6%; P < .001), chronic obstructive pulmonary disease/chronic bronchitis/emphysema (38.7% vs. 26.2%; P < .001), asthma (30.1% vs. 18.7%; P < .001), any solid cancer (11.2% vs. 8.4%; P = .046), leukemia (1.9% vs. 0.9%; P = .046), and prior receipt of antiviral therapy and influenza and pneumococcal vaccines. Race/ethnicity distributions, smoking status and BMI were similar between the two groups, Ackerson and colleagues found.

Using these data, the researchers determined that hospitalization for RSV, which was associated with a longer hospital stay and increased frequency of diagnosis for pulmonary complications, led to costs at least as great as those for influenza: $16,034 vs. $15,163 (95% CI for the difference, –$811, $2,547).

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“The costs associated with hospitalization of older adults with RSV were at least as great as that for older adults hospitalized with influenza. Furthermore, since previous findings indicate that post-hospitalization home health utilization and long-term mortality for those hospitalized with RSV were even greater than for those hospitalized with influenza, recognition of the seriousness of RSV infection in older adults and early interventions are essential,” Ackerson said. “Drawing attention to the high cost of hospitalization of older adults with RSV infection will increase awareness of the burden of RSV disease in this population, leading to earlier diagnosis and more optimal management, particularly once therapeutic and vaccine agents become available.”