Incidence and Burden of Respiratory Syncytial Virus-Associated Hospitalizations Among People 65 and Older in France: A National Hospital Database Study.

Background: Respiratory Syncytial Virus (RSV) presents a serious threat to older adults, particularly those with chronic conditions, and may lead to severe issues. Hospitalizations are frequently underreported due to diagnostic challenges and a lack of standardized testing. This study estimates national-level RSV hospitalization rates and examines the clinical and economic burden in high-risk elderly populations in France.

Method: RSV-coded hospitalizations (2017-2022) were identified using the French National Hospital Discharge database. A correction factor, derived from virological data from two local hospitals, was applied to adjust for under-reporting. Incidence rates were calculated using demographic data, focusing on adults aged 75+ and high-risk individuals aged 65-74 with comorbidities. Hospitalization characteristics and costs were also analyzed.

Results: For adults aged 75+, the adjusted incidence of RSV hospitalizations ranged from 85 to 221 per 100,000. Inpatient mortality was 8.9%-10.4%, and annual adjusted costs ranged from €27 to €76 million, with intensive care units (ICU) admissions contributing heavily. High-risk adults aged 65-74 had higher adjusted incidence rates (161-735 per 100,000), along with increased ICU admission rates and disproportionately higher costs due to intensive care needs.

Conclusions: The significant burden of RSV on adults aged 75+ and high-risk adults aged 65-74 with chronic conditions remains underreported. Improved diagnostics and targeted vaccination programs are essential to reduce hospitalizations, mortality, and healthcare costs in these vulnerable groups.