BACKGROUND: Respiratory syncytial virus (RSV) hospitalizations identified using diagnosis codes are vastly underestimated, with reported sensitivity of 6%. Recognizing the importance of understanding RSV-associated morbidity among adults ≥60 years and also considering racial/ethnic inequalities, this study assessed rates of RSV-attributable hospitalizations among adults ≥60 years by race/ethnicity in the United States (US).
METHODS: The 2016-2019 National Inpatient Sample databases were used to identify hospitalizations coded for RSV and RSV-attributable conditions (i.e., pneumonia, chronic obstructive pulmonary disease [COPD], congestive heart failure [CHF], asthma, acute respiratory infections [ARI], and influenza) among patients ≥60 years. Literature-derived proportions for each condition were used to estimate RSV-attributable hospitalizations for each RSV season (i.e., October-April) by race/ethnicity (i.e., non-Hispanic Blacks, Hispanics, non-Hispanic Whites, non-Hispanic others). Rates per 100,000 US population (≥60 years) were computed.
RESULTS: The annual rate of RSV-coded hospitalizations was 36.5 per 100,000 US population (non-Hispanic Blacks, 35.6; Hispanics, 35.4; non-Hispanic Whites, 36.7; non-Hispanic others, 36.6). Including RSV-attributable hospitalizations, the annual rate of RSV hospitalizations ranged from 373 to 533 hospitalizations per 100,000 US population. By race/ethnicity, the highest hospitalization rate per 100,000 US population was reported for non-Hispanic Black (452-634), followed by non-Hispanic White (377-544), non-Hispanic other (302-413), and Hispanic (298-407) (Figure).
CONCLUSION: Rates for RSV-coded hospitalizations were similar by race/ethnicity; however, considerable differences were observed when RSV-attributable hospitalizations were included. Rates for RSV-attributable COPD and CHF hospitalizations were higher for non-Hispanic Blacks. Overall, RSV is associated with a substantial number of hospitalizations among adults ≥60 years in the US.
