Thomas Christine M, Raman Rameela, Schaffner William, Markus Tiffanie M, Ndi Danielle, Fill Mary-Margaret A, Dunn John R, Talbot H Keipp
Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Communicable and Environmental Diseases and Emergency Preparedness Division, Tennessee Department of Health, Nashville, Tennessee, USA.
Open Forum Infect Dis. 2024 Mar 29;11(5):ofae184. doi: 10.1093/ofid/ofae184. eCollection 2024 May.
Respiratory syncytial virus (RSV) can cause hospitalization in young children and older adults. With vaccines and monoclonal antibody prophylaxis increasingly available, identifying social factors associated with severe illnesses can guide mitigation efforts.
Using data collected by the RSV Hospitalization Surveillance Network from 2016 to 2023, we identified RSV hospitalizations in Tennessee. We linked hospitalization information (eg, patient demographic characteristics and outcome) with population-level variables (eg, social vulnerability and health care insurance coverage) from publicly available data sets using census tract of residence. Hospitalization incidence was calculated and stratified by period (2016-2020 and 2020-2023). We modeled social vulnerability effect on hospitalization incidence using Poisson regression.
Among 2687 RSV hospitalizations, there were 677 (25.2%) intensive care unit admissions and 38 (1.4%) deaths. The highest RSV hospitalization incidences occurred among children aged <5 years and adults aged ≥65 years: 272.8 per 100 000 person-years (95% CI, 258.6-287.0) and 60.6 (95% CI, 56.0-65.2), respectively. Having public health insurance was associated with higher hospitalization incidence as compared with not having public insurance: 60.5 per 100 000 person-years (95% CI, 57.6-63.4) vs 14.3 (95% CI, 13.4-15.2). Higher hospitalization incidence was associated with residing in a census tract in the most socially vulnerable quartile vs the least vulnerable quartile after adjusting for age, sex, and period (incidence rate ratio, 1.4; 95% CI, 1.3-1.6).
RSV hospitalization was associated with living in more socially vulnerable census tracts. Population measures of social vulnerability might help guide mitigation strategies, including vaccine and monoclonal antibody promotion and provision to reduce RSV hospitalization.
呼吸道合胞病毒（RSV）可导致幼儿和老年人住院。随着疫苗和单克隆抗体预防措施越来越容易获得，识别与严重疾病相关的社会因素可以指导缓解措施。
利用RSV住院监测网络2016年至2023年收集的数据，我们确定了田纳西州的RSV住院病例。我们使用居住普查区将住院信息（如患者人口统计学特征和结局）与公开数据集中的人口水平变量（如社会脆弱性和医疗保险覆盖范围）相联系。计算住院发病率并按时间段（2016 - 2020年和2020 - 2023年）分层。我们使用泊松回归对社会脆弱性对住院发病率的影响进行建模。
在2687例RSV住院病例中，有677例（25.2%）入住重症监护病房，38例（1.4%）死亡。RSV住院发病率最高的是年龄小于5岁的儿童和年龄≥65岁的成年人：分别为每10万人年272.8例（95%置信区间，258.6 - 287.0）和60.6例（95%置信区间，56.0 - 65.2）。与没有公共保险相比，拥有公共医疗保险与更高的住院发病率相关：每10万人年60.5例（95%置信区间，57.6 - 63.4）对14.3例（95%置信区间，13.4 - 15.2）。在调整年龄、性别和时间段后，居住在社会最脆弱四分位数普查区的住院发病率高于最不脆弱四分位数普查区（发病率比，1.4；95%置信区间，1.3 - 1.6）。
RSV住院与居住在社会更脆弱的普查区有关。社会脆弱性的人口指标可能有助于指导缓解策略，包括推广和提供疫苗及单克隆抗体以减少RSV住院。
