MMWR Morb Mortal Wkly Rep. 2023 Oct 6;72(40):1075-1082. doi: 10.15585/mmwr.mm7240a1.
Respiratory syncytial virus (RSV) causes substantial morbidity and mortality in older adults. In May 2023, two RSV vaccines were approved for prevention of RSV lower respiratory tract disease in adults aged ≥60 years. In June 2023, CDC recommended RSV vaccination for adults aged ≥60 years, using shared clinical decision-making. Using data from the Respiratory Syncytial Virus-Associated Hospitalization Surveillance Network, a population-based hospitalization surveillance system operating in 12 states, this analysis examined characteristics (including age, underlying medical conditions, and clinical outcomes) of 3,218 adults aged ≥60 years who were hospitalized with laboratory-confirmed RSV infection during July 2022-June 2023. Among a random sample of 1,634 older adult patients with RSV-associated hospitalization, 54.1% were aged ≥75 years, and the most common underlying medical conditions were obesity, chronic obstructive pulmonary disease, congestive heart failure, and diabetes. Severe outcomes occurred in 18.5% (95% CI = 15.9%-21.2%) of hospitalized patients aged ≥60 years. Overall, 17.0% (95% CI = 14.5%-19.7%) of patients with RSV infection were admitted to an intensive care unit, 4.8% (95% CI = 3.5%-6.3%) required mechanical ventilation, and 4.7% (95% CI = 3.6%-6.1%) died; 17.2% (95% CI = 14.9%-19.8%) of all cases occurred in long-term care facility residents. These data highlight the importance of prioritizing those at highest risk for severe RSV disease and suggest that clinicians and patients consider age (particularly age ≥75 years), long-term care facility residence, and underlying medical conditions, including chronic obstructive pulmonary disease and congestive heart failure, in shared clinical decision-making when offering RSV vaccine to adults aged ≥60 years.
呼吸道合胞病毒(RSV)会导致老年人出现大量的发病率和死亡率。2023 年 5 月,两种 RSV 疫苗被批准用于预防 60 岁以上成年人的 RSV 下呼吸道疾病。2023 年 6 月,CDC 建议 60 岁以上成年人使用共享临床决策接种 RSV 疫苗。本分析使用了 12 个州的基于人群的住院监测系统——呼吸道合胞病毒相关住院监测网络的数据,该系统监测了实验室确诊的 RSV 感染住院的 3218 名 60 岁以上成年人的特征(包括年龄、潜在医疗条件和临床结局)。在随机抽取的 1634 名与 RSV 相关住院的老年患者中,54.1%年龄≥75 岁,最常见的潜在医疗条件是肥胖、慢性阻塞性肺疾病、充血性心力衰竭和糖尿病。60 岁以上住院患者的严重结局发生率为 18.5%(95%CI=15.9%-21.2%)。总体而言,17.0%(95%CI=14.5%-19.7%)的 RSV 感染患者入住重症监护病房,4.8%(95%CI=3.5%-6.3%)需要机械通气,4.7%(95%CI=3.6%-6.1%)死亡;所有病例的 17.2%(95%CI=14.9%-19.8%)发生在长期护理机构居民中。这些数据突出了优先考虑那些患严重 RSV 疾病风险最高的人群的重要性,并表明临床医生和患者在向 60 岁以上成年人提供 RSV 疫苗时,应考虑年龄(特别是年龄≥75 岁)、长期护理机构居住情况以及慢性阻塞性肺疾病和充血性心力衰竭等潜在医疗条件,以便进行共享临床决策。