Respiratory Syncytial Virus-Related Complications and Healthcare Costs Among a Medicare-Insured Population in the United States

In this real-world study, nearly half of Medicare beneficiaries experienced a respiratory syncytial virus (RSV)-related complication within 1 month of RSV diagnosis. Presence of complications/comorbidities of interest pre-RSV diagnosis predicted a higher risk of having a different complication following diagnosis. Background Literature describing respiratory syncytial virus (RSV)-related complications in older adults in the United States is scarce. This study described risk factors of RSV-related complications and healthcare costs of Medicare-insured patients aged >= 60 years with medically attended RSV. Methods 100% Medicare Research Identifiable Files (1 January 2007-31 December 2019) were used to identify adults aged >= 60 years with RSV (index: first diagnosis date). Predictors of >= 1 RSV-related complication (ie, pneumonia, acute respiratory failure, congestive heart failure, hypoxia/dyspnea, non-RSV lower/upper respiratory tract infections, or chronic respiratory disease) during the up to 6-month post-RSV diagnosis period were identified. Patients with all aforementioned diagnoses during the 6 months pre-index could not be evaluated for a complication and were therefore ineligible for analyses. Differences between 6-month pre- and post-index total all-cause and respiratory/infection-related healthcare costs were assessed. Results Overall, 175 392 patients with RSV were identified. Post-RSV diagnosis, 47.9% had >= 1 RSV-related complication, with mean time-to-event of 1.0 month. The most common complications were pneumonia (24.0%), chronic respiratory disease (23.6%), and hypoxia or dyspnea (22.0%). Baseline predictors of >= 1 RSV-related complication included having previous diagnoses for complication/comorbidity listed in the Methods, hypoxemia, chemotherapy, chest radiograph, stem cell transplant, and anti-asthmatic and bronchodilator use. Total all-cause and respiratory/infection-related healthcare costs were $7797 and $8863 higher, respectively, post-index versus pre-index (both P < .001). Conclusions In this real-world study, almost half of patients with medically attended RSV experienced an RSV-related complication within 1 month post-RSV diagnosis, and costs significantly increased post-diagnosis. Having a complication/comorbidity pre-RSV predicted a higher risk of developing a different complication post-RSV infection.

Automated summary

In this real-world study, nearly half of Medicare beneficiaries experienced a respiratory syncytial virus (RSV)-related complication within 1 month of RSV diagnosis. Having complications/comorbidities prior to RSV diagnosis predicted a higher risk of developing different complications after diagnosis. This study provides valuable insights into the risk factors and healthcare costs associated with RSV-related complications in older adults.