Respiratory Syncytial Virus and Human Metapneumovirus Respiratory Hospitalizations and Outcomes in Colorado Adults ≥50 Years of Age: 2016–2023 - Report - MDSpire
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Respiratory Syncytial Virus and Human Metapneumovirus Respiratory Hospitalizations and Outcomes in Colorado Adults ≥50 Years of Age: 2016–2023
Hospitalization Rates and Outcomes for RSV and HMPV in Adults ≥50 in Colorado
Overview
This retrospective cohort study analyzed hospitalization data from 2016 to 2023 for adults aged 50 and older in Colorado, comparing respiratory syncytial virus (RSV) and human metapneumovirus (HMPV) infections. Key findings include distinct comorbidity risk profiles for ICU admission and mortality between RSV and HMPV, with COPD and neuromuscular diseases being significant predictors.
Background
Respiratory syncytial virus (RSV) is a well-recognized cause of severe acute respiratory infections in older adults, with established data on hospitalization and mortality risks. Human metapneumovirus (HMPV), discovered just over 20 years ago, is also implicated in acute respiratory infections but its disease burden in older adults is less understood. Multiplex viral testing and ICD-10 coding improvements have facilitated better identification of these infections in hospital databases. This study leverages the Colorado Hospital Association database to evaluate demographic and comorbid factors influencing outcomes in adults aged 50 and older hospitalized with RSV or HMPV.
Data Highlights
Comorbidity
RSV ICU Admission aOR (95% CI)
HMPV ICU Admission aOR (95% CI)
RSV Mortality aOR (95% CI)
HMPV Mortality aOR (95% CI)
Chronic Obstructive Pulmonary Disease (COPD)
2.24 (1.81–2.77)
2.99 (2.13–4.19)
Not highest risk
12.44 (3.02–51.17)
Neuromuscular Disease without Dementia
2.33 (1.98–2.75)
2.22 (1.75–2.80)
Not highest risk
Not highest risk
Neurological Disorders with Dementia
Not highest risk
Not highest risk
4.16 (3.01–5.77)
Not highest risk
Key Findings
Chronic obstructive pulmonary disease (COPD) significantly increased the risk of ICU admission for both RSV (aOR 2.24) and HMPV (aOR 2.99) infections.
Neuromuscular disease without dementia was also associated with increased ICU admission risk for RSV (aOR 2.33) and HMPV (aOR 2.22).
Age was a significant predictor of mortality in RSV-infected patients but not in those infected with HMPV.
Neurological disorders with dementia were the strongest comorbid risk factor for mortality in RSV infections (aOR 4.16).
COPD was the highest comorbid risk factor for mortality in HMPV infections (aOR 12.44), indicating a distinct risk profile from RSV.
HMPV poses a unique disease burden in older adults, with specific high-risk comorbidities differing from those of RSV.
Clinical Implications
Clinicians should recognize that COPD and neuromuscular diseases significantly increase the risk of ICU admission in older adults hospitalized with RSV or HMPV. Mortality risk factors differ between the two viruses, with dementia increasing risk in RSV and COPD in HMPV, suggesting tailored management strategies may be warranted. Awareness of these distinct risk profiles can guide risk stratification and resource allocation in hospital settings.
Conclusion
This study highlights distinct comorbidity-related risks for ICU admission and mortality in adults aged 50 and older hospitalized with RSV versus HMPV in Colorado. Understanding these differences is critical for optimizing clinical care and informing future research on these respiratory viruses in older populations.
References
Piedra et al and Greenbaum et al 2023 -- ICD-10 classifications for respiratory infections
Colorado Hospital Association Database 2016-2023 -- Hospitalization data for respiratory infections
CDC 2023 -- RSV vaccine guidelines for older adults
