Incidence and Burden of Respiratory Syncytial Virus (RSV) Associated Hospitalizations among People 65 and Older in France: A National Hospital Database Study

Background RSV presents a serious threat to older adults, particularly those with chronic conditions, and may lead to severe issues. Hospitalizations are frequently underreported due to diagnostic challenges and a lack of standardized testing. This study estimates national level RSV hospitalization rates and examines the clinical and economic burden in high-risk elderly populations in France. Methods RSV-coded hospitalizations (2017-2022) were identified using the French National Hospital Discharge database. A correction factor, derived from virological data from two local hospitals, was applied to adjust for under-reporting. Incidence rates were calculated using demographic data, focusing on adults aged 75+ and high-risk individuals aged 65-74 with comorbidities. Hospitalization characteristics and costs were also analyzed. Results For adults aged 75+, the adjusted incidence of RSV hospitalizations ranged from 85 to 221 per 100,000. Inpatient mortality was 8.9%-10.4%, and annual adjusted costs ranged from €27 to €76 million, with ICU admissions contributing heavily. High-risk adults aged 65-74 had higher adjusted incidence rates (161 to 735 per 100,000), along with increased ICU admission rates and disproportionately higher costs due to intensive care needs. Conclusions The significant burden of RSV on adults aged 75+ and high-risk adults aged 65-74 with chronic conditions remains underreported. Improved diagnostics and targeted vaccination programs are essential to reduce hospitalizations, mortality, and healthcare costs in these vulnerable groups.