Evaluation of Chronic Conditions and Severe Outcomes in Adults Aged 18-59 Years With Medically Attended RSV Illness Using U.S. Commercial Claims Data
Author(s)
Daniel K. Nomah, MD, MSc, PhD1, John Shen, MSPH2, Neloufar Rahai, PhD, MPH2, Meng Wang, PhD3, Linwei Li, MS in Biostatistics3, Isabella Lelis, BA2, Miao Jiang, PhD3, Genelle Goodhue, BS3, Parinaz Ghaswalla, PhD3, Beverly Francis, PhD3, Catherine A. Panozzo, PhD3, Claire E. Newbern, PhD, MPH3, Elissa Wilker, ScD3, Zhe Zheng, PhD3.
1Aetion Iberia, S.L., Barcelona, Spain, 2Aetion, Inc., New York, NY, USA, 3Moderna, Inc., Cambridge, MA, USA.
1Aetion Iberia, S.L., Barcelona, Spain, 2Aetion, Inc., New York, NY, USA, 3Moderna, Inc., Cambridge, MA, USA.
OBJECTIVES: Respiratory syncytial virus (RSV) is a well-known cause of severe respiratory disease, particularly in pediatric and elderly populations. Less is known about its impact on younger adults and how chronic conditions exacerbate severity. This study aims to describe the most prevalent chronic conditions among U.S. adults aged 18-59 years with acute medically-attended RSV (MA-RSV) illness and evaluate associations with severe outcomes.
METHODS: A retrospective cohort study using Optum’s de-identified Clinformatics® DataMart included adults aged 18-59 years with MA-RSV illness, defined as ICD-10-coded RSV diagnosis in any care setting during the 2022-23 and 2023-24 seasons. Index date was the first MA-RSV-related encounter date. We assessed baseline chronic conditions (per CDC guidance) 365 days pre-index and severe outcomes (mechanical ventilation, hospitalization, ICU admission, death) 30 days post-index. Adjusted risk ratios (aRRs) for associations between chronic conditions and severe outcomes were estimated using multivariable models adjusting for demographics.
RESULTS: Among 1,435 MA-RSV patients in 2022-23 and 1,890 in 2023-24, 74% (2022-23) and 77% (2023-24) had ≥1 chronic condition, with cardiovascular disease, chronic respiratory disease, immunocompromised status, obesity, and diabetes being the most prevalent. In both seasons, approximately 21% of MA-RSV patients had at least one severe outcome. Among RSV hospitalized patients, 44% required ICU admission (median stay: 6 days), and 37% required oxygen support. Individuals with chronic conditions had significantly higher risks of severe outcomes, with chronic respiratory disease (aRR: 3.62 [95%CI: 2.62-5.01]; 5.93 [95%CI: 4.24-8.31]), cardiovascular disease (aRR: 2.28 [95%CI: 1.56-3.32]; 1.90 [95%CI: 1.37-2.64]), and neurological conditions (aRR: 1.26 [95%CI: 0.94-1.69]; 1.37 [95%CI: 1.09-1.72]) posing increased risks in 2022-23 and 2023-24, respectively.
CONCLUSIONS: Over three-quarters of MA-RSV patients aged 18-59 years have at least one chronic condition. Underlying conditions increase the risk of severe RSV outcomes in this population. Vaccines are crucial to mitigate severe outcomes.
METHODS: A retrospective cohort study using Optum’s de-identified Clinformatics® DataMart included adults aged 18-59 years with MA-RSV illness, defined as ICD-10-coded RSV diagnosis in any care setting during the 2022-23 and 2023-24 seasons. Index date was the first MA-RSV-related encounter date. We assessed baseline chronic conditions (per CDC guidance) 365 days pre-index and severe outcomes (mechanical ventilation, hospitalization, ICU admission, death) 30 days post-index. Adjusted risk ratios (aRRs) for associations between chronic conditions and severe outcomes were estimated using multivariable models adjusting for demographics.
RESULTS: Among 1,435 MA-RSV patients in 2022-23 and 1,890 in 2023-24, 74% (2022-23) and 77% (2023-24) had ≥1 chronic condition, with cardiovascular disease, chronic respiratory disease, immunocompromised status, obesity, and diabetes being the most prevalent. In both seasons, approximately 21% of MA-RSV patients had at least one severe outcome. Among RSV hospitalized patients, 44% required ICU admission (median stay: 6 days), and 37% required oxygen support. Individuals with chronic conditions had significantly higher risks of severe outcomes, with chronic respiratory disease (aRR: 3.62 [95%CI: 2.62-5.01]; 5.93 [95%CI: 4.24-8.31]), cardiovascular disease (aRR: 2.28 [95%CI: 1.56-3.32]; 1.90 [95%CI: 1.37-2.64]), and neurological conditions (aRR: 1.26 [95%CI: 0.94-1.69]; 1.37 [95%CI: 1.09-1.72]) posing increased risks in 2022-23 and 2023-24, respectively.
CONCLUSIONS: Over three-quarters of MA-RSV patients aged 18-59 years have at least one chronic condition. Underlying conditions increase the risk of severe RSV outcomes in this population. Vaccines are crucial to mitigate severe outcomes.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH156
Topic
Epidemiology & Public Health
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Infectious Disease (non-vaccine)