P-683. Estimation of RSV-attributable cardiovascular and respiratory hospitalizations in adults in Germany between 2015–2019
Authors: Beese Caroline , Liang Caihua , Johanna Bayer Lea , Huebbe Bennet , Peerawaranun Pimnara , Bruyndonckx Robin , Polkowska-Kramek Aleksandra , Casas Maribel , Phuong Tran Thao Mai , Ewnetu Worku Biyadgie , Von Eiff Christof , Gessner Bradford D , Begier Elizabeth , Rohde Gernot 
Published: January 2025

Abstract

Background
RSV can cause severe outcomes among adults, especially those with underlying comorbidities. However, RSV incidence in adults is frequently underestimated due to non-specific symptomatology, limited standard-of-care testing and lower test sensitivity compared to infants. To address these gaps, we conducted a retrospective study to estimate RSV-attributable incidence of hospitalizations among adults in Germany between 2015–2019.

Methods
Information on hospitalizations was gathered from a Statutory Health Insurance (SHI) database. A quasi-Poisson regression model was fitted to estimate RSV-attributable incidence rate (IR) of four specific cardiovascular hospitalizations (arrythmia, ischemic heart diseases, chronic heart failure exacerbations, cerebrovascular diseases) and four specific respiratory hospitalizations (influenza/pneumonia, bronchitis/bronchiolitis, chronic lower respiratory diseases, upper respiratory diseases) accounting for within-season fluctuations and virus activity stratified by age groups (18–44, 45–59, ≥60, 60–74, ≥75 years).

Results
RSV-attributable IRs of hospitalizations were generally increasing with age. Among cardiovascular hospitalizations in adults aged ≥60 years, arrythmia and ischemic heart diseases accounted for the highest incidence, followed by chronic heart failure exacerbation, with annual IR ranges of 157–260, 133–214, and 105–169 per 100,000 person-years, respectively. Among respiratory hospitalizations, highest RSV-attributable incidence in adults aged ≥60 years were for chronic lower respiratory diseases and bronchitis/bronchiolitis, with annual IR ranges of 103–168 and 77­­–122 per 100,000 person-years, respectively.

Conclusion
RSV infection is a well-established trigger for chronic heart failure exacerbations, but in this study RSV-related arrythmia and ischemic events were detected to have a higher incidence. RSV causes a considerable burden of both respiratory and cardiovascular hospitalizations in adults in Germany, similar to other respiratory viruses (e.g., influenza and SARS-CoV-2). This highlights the need to implement effective prevention strategies, especially for the older adults.

Disclosures
Caroline Beese, n/a, Pfizer Pharma GmbH: Employee Caihua Liang, MD, PhD, Pfizer: Stocks/Bonds (Private Company) Lea Johanna Bayer, n/a, Pfizer Pharma: Employee Bennet Huebbe, n/a, Pfizer Pharma GmbH: Ex-employee Aleksandra Polkowska-Kramek, n/a, Pfizer: employee of P95 which received funding from Pfizer to conduct this study Maribel Casas, PhD, Pfizer: Advisor/Consultant Christof Von Eiff, n/a, Pfizer Pharma: I am working as Sen. Medical Direktor for Vaccines at Pfizer Pharma GmbH, Berlin, , Germany and in that position I also get stocks. Bradford D. Gessner, M.D., M.P.H., Pfizer: Employee|Pfizer: Stocks/Bonds (Public Company) Elizabeth Begier, MD, M.P.H., Pfizer Vaccines: Employee|Pfizer Vaccines: Stocks/Bonds (Private Company) Gernot Rohde, MD, Astra Zeneca: Advisor/Consultant|Astra Zeneca: Honoraria|Berlin Chemie: Honoraria|Boehringer Ingelheim: Honoraria|GSK: Advisor/Consultant|GSK: Honoraria|Insmed: Advisor/Consultant|Insmed: Honoraria|Pfizer: Honoraria|sanofi: Advisor/Consultant|sanofi: Honoraria