成人の健康におけるRSVの隠れた影響

タイトル: Estimated incidence rate of specific cardiovascular and respiratory hospitalizations attributable to Respiratory Syncytial Virus among adults in Germany between 2015 and 2019

概要: IntroductionRespiratory syncytial virus (RSV) can cause severe outcomes among adults. However, 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 hospitalizations among adults in Germany between 2015 and 2019. MethodsInformation on hospitalizations and the number of people at risk of hospitalization (denominator) was gathered from a Statutory Health Insurance (SHI) 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, cerebrovascular diseases) and four specific respiratory hospitalizations (influenza/pneumonia, bronchitis/bronchiolitis, chronic lower respiratory tract diseases, upper respiratory tract diseases). ResultsRSV-attributable IRs of hospitalizations were generally increasing with age. Among 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 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. ConclusionRSV 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. Key Summary PointsO_LIRespiratory syncytial virus (RSV) disease burden in adults is significant yet often remains unrecognized due to unspecific symptoms, lack of routine testing and lower test sensitivity compared to infants. C_LIO_LIUsing a quasi-Poisson regression time-series model, we estimated the age-stratified RSV-attributable incidence of specific cardiovascular and respiratory hospitalizations in Germany between 2015 and 2019. C_LIO_LIEstimated cardiorespiratory RSV hospitalization rates increased with age and were significantly higher in older adults. C_LIO_LIArrhythmia, ischemic heart diseases, and chronic lower respiratory tract disease exacerbation were the most frequent causes of RSV-attributable cardiovascular and respiratory hospitalizations. C_LIO_LIRSV causes a considerable burden of respiratory and cardiovascular hospitalizations among adults in Germany, and effective RSV vaccines could improve public health outcomes, especially for older adults. C_LI