Zhang Tiantian, Reeves Rachel M, Ma Shihao, Miao Yumeng, Sun Shiqi, Orrico-Sánchez Alejandro, Panning Marcus, Urchueguía-Fornes Arantxa, Vuichard-Gysin Danielle, Nair Harish, Fonseca Maria João, Marijam Alen, Wang Xin, Li You
Department of Epidemiology, National Vaccine Innovation Platform, School of Public Health, Nanjing Medical University, Nanjing, China.
GSK, Philadelphia, US.
BMC Med. 2025 Aug 4;23(1):453. doi: 10.1186/s12916-025-04249-x.
With respiratory syncytial virus vaccines recently approved for use among older adults, country-level respiratory syncytial virus (RSV) disease burden estimates are needed to inform local RSV immunisation strategy. We aimed to estimate country-level RSV hospitalisation burden in older adults in Europe.
We compiled data on RSV hospitalisation burden in adults aged ≥ 60 years in Europe from published studies (systematic review: PROSPERO CRD42024516945), surveillance data, and unpublished data from international collaborators. We adjusted for diagnostic testing, clinical specimens, and case definitions through statistical modelling techniques and generated country-level hospitalisation rate estimates; for countries with no available data, we developed an ensemble model to predict RSV hospitalisation rates. We also estimated RSV in-hospital case fatality ratio (hCFR) for countries with available data.
We included 14 studies (3 unpublished studies). The adjusted RSV-associated hospitalisation rates were overall 2.2 to 6.4 times higher than unadjusted estimates. Among 5 countries with available data, adjusted annual RSV hospitalisation rates ranged from 193/100,000 person-years in the Netherlands (95% confidence interval [CI]: 125-304) and Finland (141-274) to 414/100,000 in Denmark (322-514). The RSV hospitalisation rates predicted by the ensemble model in 23 additional countries ranged from 223/100,000 to 317/100,000 person-years. RSV hCFR ranged from 6.73% (4.63-9.69) in Spain to 10.14% (4.91-19.79) in Switzerland.
This study addresses knowledge gaps in RSV hospitalisation burden among older adults in Europe while highlighting the importance of adjusting for RSV case under-ascertainment. These findings might be relevant for country's considerations of RSV immunisation strategies for older adults.
随着呼吸道合胞病毒疫苗最近被批准用于老年人，需要国家层面的呼吸道合胞病毒（RSV）疾病负担估计来为当地的RSV免疫策略提供信息。我们旨在估计欧洲国家层面老年人的RSV住院负担。
我们从已发表的研究（系统评价：PROSPERO CRD42024516945）、监测数据以及国际合作者的未发表数据中收集了欧洲≥60岁成年人RSV住院负担的数据。我们通过统计建模技术对诊断检测、临床标本和病例定义进行了调整，并生成了国家层面的住院率估计值；对于没有可用数据的国家，我们开发了一个综合模型来预测RSV住院率。我们还估计了有可用数据国家的RSV院内病死率（hCFR）。
我们纳入了14项研究（3项未发表研究）。经调整后的RSV相关住院率总体比未调整估计值高2.2至6.4倍。在5个有可用数据的国家中，经调整的年度RSV住院率范围从荷兰的193/100,000人年（95%置信区间[CI]：125 - 304）和芬兰的（141 - 274）到丹麦的414/100,000（322 - 514）。综合模型预测的另外23个国家的RSV住院率范围为223/100,000至317/100,000人年。RSV hCFR范围从西班牙的6.73%（4.63 - 9.69）到瑞士的10.14%（4.91 - 19.79）。
本研究填补了欧洲老年人RSV住院负担方面的知识空白，同时强调了对RSV病例漏报情况进行调整的重要性。这些发现可能与各国对老年人RSV免疫策略的考量相关。
