Zheng Zhe, Warren Joshua L, Shapiro Eugene D, Pitzer Virginia E, Weinberger Daniel M
Department of Epidemiology of Microbial Diseases and the Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, CT, USA.
Department of Biostatistics and the Public Health Modeling Unit, Yale School of Public Health, Yale University, New Haven, CT, USA.
Pneumonia (Nathan). 2022 Oct 25;14(1):6. doi: 10.1186/s41479-022-00098-x.
Surveillance for respiratory syncytial virus (RSV) likely captures just a fraction of the burden of disease. Understanding the burden of hospitalizations and disparities between populations can help to inform upcoming RSV vaccine programs and to improve surveillance.
We obtained monthly age-, ZIP code- and cause-specific hospitalizations in New York, New Jersey, and Washington from the US State Inpatient Databases (2005-2014). We estimated the incidence of respiratory hospitalizations attributable to RSV by age and by socioeconomic status using regression models. We compared the estimated incidence and the recorded incidence (based on ICD9-CM) of RSV hospitalizations to estimate the under-recorded ratio in different subpopulations.
The estimated annual incidence of respiratory hospitalizations due to RSV was highest among infants < 1 year of age with low socioeconomic status (2800, 95% CrI [2600, 2900] per 100,000 person-years). We also estimated a considerable incidence in older adults (≥ 65 years of age), ranging from 130 to 960 per 100,000 person-years across different socioeconomic strata. The incidence of hospitalization recorded as being due to RSV represented a significant undercount, particularly in adults. Less than 5% of the estimated RSV hospitalizations were captured for those ≥ 65 years of age.
RSV causes a considerable burden of hospitalization in young children and in older adults in the US, with variation by socioeconomic group. Recorded diagnoses substantially underestimate the incidence of hospitalization due to RSV in older adults.
呼吸道合胞病毒（RSV）监测可能仅涵盖了该疾病负担的一小部分。了解住院负担及不同人群之间的差异有助于为即将开展的RSV疫苗计划提供信息并改善监测。
我们从美国州住院数据库（2005 - 2014年）获取了纽约、新泽西和华盛顿按年龄、邮政编码及病因分类的月度住院数据。我们使用回归模型按年龄和社会经济地位估算了RSV所致呼吸道住院的发病率。我们比较了RSV住院的估算发病率和记录发病率（基于ICD9 - CM），以估算不同亚人群中记录不足的比例。
社会经济地位低的1岁以下婴儿中，RSV所致呼吸道住院的估计年发病率最高（每10万人年2800例，95%可信区间[2600, 2900]）。我们还估计老年人（≥65岁）的发病率相当可观，不同社会经济阶层每10万人年的发病率在130至960例之间。记录为因RSV导致的住院发病率存在显著漏报，尤其是在成年人中。65岁及以上人群中，估计的RSV住院病例不到5%被记录。
在美国，RSV给幼儿和老年人造成了相当大的住院负担，且因社会经济群体而异。记录的诊断结果大大低估了老年人中RSV所致住院的发病率。
