Clinical Scorecard: Hospitalization Rates and Outcomes for Respiratory Syncytial Virus and Human Metapneumovirus in Adults Aged 50 and Older in Colorado: A Study from 2016 to 2023

At a Glance

Key Highlights

• Chronic obstructive pulmonary disease (COPD) and neuromuscular disease without dementia are major risk factors for ICU admission in both RSV and HMPV infections.
• Age significantly increases mortality risk in RSV-infected patients but not in those infected with HMPV.
• Neurological disorders with dementia are the highest comorbid risk factor for RSV mortality, whereas COPD is the highest risk factor for HMPV mortality.

Guideline-Based Recommendations

Diagnosis

• Use ICD-10 coding to identify RSV and HMPV infections in hospitalized adults.
• Consider multiplex viral nucleic acid testing for respiratory pathogens including RSV and HMPV, especially in older adults with acute respiratory infections.

Management

• Recognize COPD and neuromuscular diseases as high-risk comorbidities warranting close monitoring and potentially aggressive management in RSV and HMPV infections.
• Apply CDC guidelines for RSV vaccination in older adults to reduce hospitalization and severe outcomes.

Monitoring & Follow-up

• Monitor patients with COPD and neuromuscular diseases closely for ICU admission risk.
• Assess mortality risk particularly in RSV patients with neurological disorders including dementia and in HMPV patients with COPD.

Risks

• Increased ICU admission risk associated with COPD and neuromuscular disease without dementia in both RSV and HMPV infections.
• Higher mortality risk in RSV patients with neurological disorders with dementia and in HMPV patients with COPD.
• Age is a significant mortality risk factor in RSV but not in HMPV infections.

Patient & Prescribing Data

Adults aged 50 and older hospitalized with RSV or HMPV infections in Colorado hospitals

RSV vaccines are licensed and recommended for older adults; treatment decisions should consider comorbidities such as COPD and neurological disorders to mitigate ICU admission and mortality risks.

Clinical Best Practices

• Identify and stratify patients by comorbidity burden, especially COPD and neuromuscular diseases, to guide clinical monitoring and intervention.
• Incorporate RSV vaccination strategies in older adults as per CDC guidelines to reduce disease burden.
• Use comprehensive diagnostic coding and consider multiplex viral testing to improve detection of RSV and HMPV infections.
• Recognize distinct risk profiles for RSV and HMPV to tailor patient management and resource allocation.

References

• Centers for Disease Control and Prevention RSV Vaccination Guidelines
• Colorado Hospital Association Database