Abstract Background Respiratory syncytial virus (RSV) causes annual outbreaks of respiratory illness with peak incidence occurring from late fall to early spring. While RSV is a leading cause of pediatric hospitalizations, it also poses a significant burden on older adults.Table 1.Cohort CharacteristicsTable 2.Multivariable-adjusted risk of supplemental oxygen, ICU needed, and stay length Methods We reviewed electronic medical records for hospitalized adults with laboratory-confirmed RSV between July 1, 2020, and June 30, 2024. Demographics, risk factors and outcomes were recorded. We created logistic and linear regression models to obtain multivariable-adjusted risks of supplemental oxygen needs, ICU level care, and increased length of stay (LOS). Results 371 patients met inclusion criteria. The cohort was predominantly older (≥65 years, 62%), White (60%), and female (57%), and were also in generally poor health (e.g., overweight BMIs, ∼50% current or former smokers, ∼50% with pulmonary or cardiovascular disease). Around one third required supplemental oxygen, 12% required ICU care and 2% died. The median LOS was 4 days, and both needing oxygen and ICU care associated with longer LOS (ps 0.001). Multivariable-adjusted models suggested patients 85 years or older were at 160% higher risk to need supplemental oxygen; current smokers were at 140% higher risk, pulmonary patients 120%, and cardiac patients 70% (ps≤0.05); Hispanic or Latine patients were 60% at lower risk (p=0.04). Patients with pulmonary disease history had a 60% lower risk of needing ICU care (p=0.02). No demographic variables predicted LOS (ps 0.06). Conclusion We identified key demographic and clinical characteristics associated with greater illness severity of RSV, including the need for supplemental oxygen and ICU care. The roughly 1 in 3 requirements for supplemental oxygen, 12% ICU admission rate, and 2% in-hospital mortality highlight the considerable burden RSV imposes on hospitalized adults. Our findings suggest that elderly adults and those with underlying cardiopulmonary disease represent particularly high-risk groups for severe RSV manifestations. Current smokers and those over age 85 each had over twice the odds of requiring supplemental oxygen compared to younger patients and never-smokers. Protocols for RSV prevention—such as vaccination, early detection, and respiratory support may help optimize hospital outcomes. Disclosures All Authors: No reported disclosures
Baker et al. (Thu,) studied this question.