1460. Respiratory Syncytial Virus (RSV)-Related Clinical Events among a Medicare-Insured Population in the United States
Authors: DeMartino Jessica K K , Lafeuille Marie-Hélène , Emond Bruno , Rossi Carmine , Wang Jingru , Liu Stephanie , Lefebvre Patrick , Krishnarajah Girishanthy 
Published: December 2022

Abstract

Background
RSV is a contagious pathogen that is often underrecognized in older adults. While the general burden of RSV has previously been assessed, little is known on the frequency and factors associated with RSV-related clinical events in older adults.

Methods
Patients ≥60 years old with a diagnosis code for RSV (index date) and ≥6 months of enrollment pre-index (baseline) were analyzed using claims data from the 100% Medicare database (2007-2019). The following RSV-related clinical events were assessed during the up-to-6-month post-index period: acute respiratory failure, chronic respiratory disease (asthma or chronic obstructive pulmonary disease), congestive heart failure, dyspnea, hypoxia, non-RSV lower/upper respiratory tract infection, and pneumonia. Patients were at risk of developing each clinical event if they did not already have the event at baseline. A stepwise Poisson regression model was used to identify baseline predictors of having ≥1 clinical event.

Results
A total of 175,392 patients were included (mean age: 79.0 years, 64.8% female, 78.4% white, 76.9% had ≥1 RSV-related clinical event at baseline). During the up-to-6-month period following RSV infection, 47.9% had ≥1 incident RSV-related clinical event (Figure). The mean (median) time to a clinical event was 1.0 (0.1) month. Having an event was more likely for patients with baseline conditions (coronary artery disease, diabetes, or one of the above RSV-related clinical events [except pneumonia and asthma]) or with chemotherapy, chest x-ray, organ transplant, anti-asthmatic use, or bronchodilator use at baseline (incidence rate ratio [IRR] range=1.06 [bronchodilators] to 1.80 [chest x-ray], all P&lt; .05); having an event was less likely for patients with one of the following: lower age, female gender, baseline influenza or RSV test, baseline use of antibiotics, or baseline use of influenza agents (IRR range=0.63 [antibiotics] to 0.92 [baseline RSV test], all P&lt; .05). FigureRSV-related clinical events among Medicare beneficiaries ≥60 years old

Conclusion
Almost half of patients ≥60 years old had an RSV-related clinical event within 1 month of RSV infection; patients with pre-existing conditions (≥75% of patients) were at higher risk of an event. These findings highlight that many older adults with RSV experience significant clinical events that burden both the patient and the healthcare system.

Disclosures
Jessica K. K. DeMartino, PhD, Janssen Scientific Affairs, LLC: Employee of Janssen Scientific Affairs, LLC Marie-Hélène Lafeuille, MSc, Janssen Scientific Affairs, LLC: Advisor/Consultant Bruno Emond, MSc, Janssen Scientific Affairs, LLC: Advisor/Consultant Carmine Rossi, PhD, Janssen Scientific Affairs, LLC: Advisor/Consultant Jingru Wang, BA, Janssen Scientific Affairs, LLC: Advisor/Consultant Stephanie Liu, MS, Janssen Scientific Affairs, LLC: Advisor/Consultant Patrick Lefebvre, MSc, Janssen Scientific Affairs, LLC: Advisor/Consultant Girishanthy Krishnarajah, MBA, Janssen Scientific Affairs, LLC: Employee of Janssen Scientific Affairs, LLC.