Hospitalization Rates and Burden of RSV in Elderly Adults in France

Overview

This national database analysis estimated that respiratory syncytial virus (RSV) causes substantial hospitalization rates, mortality, and healthcare costs among elderly adults in France, particularly those aged 75+ and high-risk adults aged 65–74 with chronic conditions. Adjusted RSV hospitalization incidence ranged from 85 to 221 per 100,000 in adults 75+, and 161 to 735 per 100,000 in high-risk adults 65–74, with inpatient mortality up to 10.4% and annual costs reaching €76 million.

Background

Respiratory syncytial virus (RSV) is a significant cause of severe respiratory illness and death in older adults, especially those with chronic diseases such as COPD, cardiovascular disease, and diabetes. Diagnosis of RSV in adults is challenging due to symptom overlap with other respiratory infections and historically limited standardized testing, leading to underreporting of hospitalizations. In France, RSV circulates seasonally from mid-October to mid-January, and recent health authority recommendations advocate vaccination for adults aged 75+ and those 65+ with respiratory or cardiac comorbidities. Combining national hospitalization data with virological testing improves estimation of RSV burden in this population.

Data Highlights

Key Findings

• RSV hospitalization incidence is substantially underreported without virological correction.
• Adults aged 75+ have an adjusted RSV hospitalization incidence between 85 and 221 per 100,000 annually.
• High-risk adults aged 65–74 with chronic conditions show even higher incidence rates, ranging from 161 to 735 per 100,000.
• Inpatient mortality for RSV hospitalizations in adults 75+ ranges from 8.9% to 10.4%.
• Annual healthcare costs attributable to RSV hospitalizations range from €27 million to €76 million, with ICU admissions driving higher costs, especially in high-risk 65–74-year-olds.
• RSV-related hospitalizations often involve prolonged stays and intensive care, increasing the clinical and economic burden.

Clinical Implications

Clinicians should recognize the significant but underreported burden of RSV in elderly patients, particularly those with chronic comorbidities. Enhanced diagnostic testing and awareness are critical to identify RSV infections accurately. Targeted vaccination programs for adults aged 75+ and high-risk adults aged 65–74 could substantially reduce hospitalizations, mortality, and healthcare costs associated with RSV.

Conclusion

RSV poses a significant health and economic burden among elderly adults in France, especially in those aged 75+ and high-risk individuals aged 65–74. Improved diagnostics and vaccination strategies are essential to mitigate this impact in vulnerable populations.

References

1. French National Authority for Health (HAS) 2022 -- RSV Vaccination Recommendations
2. French National Hospital Discharge Database (PMSI) -- Data Source
3. Virological Data from Pitié-Salpêtrière and Bichat Claude Bernard Hospitals -- RSV Testing