Study Identifies Risk Profiles for Severe RSV Outcomes in Hospitalized Adults
A multi-state study of adults hospitalized with respiratory syncytial virus (RSV) highlights distinct risk profiles tied to severe outcomes, underscoring the importance of considering multimorbidity in clinical management and prevention strategies.
Researchers analyzed data from 1111 adults admitted with RSV across 26 hospitals in 20 US states between January 2022 and July 2024. The median patient age was 66 years. The study examined 17 underlying conditions using Bayesian profile regression, with results stratified by age group.
Among adults aged 18-59 years (n = 397), 2 primary profiles emerged. One group, characterized by fewer underlying conditions, had an intensive care unit (ICU) admission risk of 21% (95% credible interval [CrI], 16% to 25%). The second, defined by cardiorenal disease and diabetes—including frequent heart failure, chronic kidney disease, and diabetes—showed a substantially higher ICU admission risk at 37% (95% CrI, 27% to 48%).
For adults aged 60 years and older (n = 714), 4 distinct profiles were observed. Those with minimal prevalence of underlying conditions had an ICU admission risk of 22% (95% CrI, 18% to 26%), while patients with cardiorenal disease and diabetes showed a 27% risk (95% CrI, 21% to 34%). A third group, defined by hematologic malignancy and transplant history, had the lowest observed ICU risk at 12% (95% CrI, 6% to 21%). The highest risk was seen in patients with chronic pulmonary disease and home oxygen dependence, who faced a 44% ICU admission risk (95% CrI, 25% to 66%).
“Distinct underlying condition profiles with varying risks of critical illness were observed among inpatients with RSV,” the authors concluded. “These findings could support recognition of high-risk patients to inform RSV prevention strategies and suggest that the role of multimorbidity in severe RSV disease risk warrants further attention.”
For payers and managed care stakeholders, these results suggest that risk stratification tools accounting for multimorbidity could enhance coverage policies and care pathways. Identifying high-risk groups, particularly those with pulmonary disease requiring home oxygen or multiple chronic conditions, may help guide allocation of preventive interventions, including vaccination and advanced therapeutics, while optimizing hospital resources.
Reference
Ma KC, Surie D, Zhu W, et al. Multimorbidity profiles and severe in-hospital outcomes in adults with respiratory syncytial virus. Clin Infect Dis. 2025;Jul:ciaf405. doi:10.1093/cid/ciaf405
