Burden Of Disease, Healthcare Resource Use and Costs of Respiratory Syncytial Virus Among Adults in Spain in 2021-2023 in the Hospital Setting: A Real-World Retrospective Observational Study of Four Hospitals
Author(s)
Triantafyllos Pliakas, PhD1, Felipe Villar-Álvarez, PhD2, Maria T. Ledo-Varela, MD3, Jesus Molina, MD4, Laura Amanda Vallejo-Aparicio, MSc5, Rutger Schim van der Loeff, MS6, Alen Marijam, MSc, PharmD7, Rachel M. Reeves, PhD8.
1Impact Epilysis, Thessaloniki, Greece and GSK, Wavre, Belgium, 2Fundación Jiménez Díaz, Madrid, Spain, 3Hospital Central de la Defensa, Madrid, Spain, 4Centro de Salud Francia Dirección Asistencial Oeste, Madrid, Spain, 5GSK, Madrid, Spain, 6LOGEX, Amsterdam, Netherlands, 7GSK, Wavre, Belgium, 8GSK, Philadelphia, PA, USA.
1Impact Epilysis, Thessaloniki, Greece and GSK, Wavre, Belgium, 2Fundación Jiménez Díaz, Madrid, Spain, 3Hospital Central de la Defensa, Madrid, Spain, 4Centro de Salud Francia Dirección Asistencial Oeste, Madrid, Spain, 5GSK, Madrid, Spain, 6LOGEX, Amsterdam, Netherlands, 7GSK, Wavre, Belgium, 8GSK, Philadelphia, PA, USA.
OBJECTIVES: Respiratory syncytial virus (RSV), influenza and coronavirus disease 2019 (COVID-19) can lead to acute respiratory infection (ARI)-related hospitalisations, which are associated with a large health and economic burden. Notably, RSV burden of disease (BoD) may be underestimated due to under-testing and under-diagnosis. In Spain, RSV BoD among adults is poorly understood. Here, we examine the concordance between microbiology-confirmed positive test data and International Classification of Diseases, 10th revision (ICD-10) diagnoses, and characterise the BoD of high-risk adults 18-49 years of age (YOA) and all adults ≥50 YOA hospitalised with RSV, influenza and COVID-19 in Spain.
METHODS: ARI-related hospital admissions were identified using ICD-10 coding. RSV, influenza and COVID-19 microbiology-confirmed positive test data for each of these hospitalisations were compared against ICD-10 diagnoses. For RSV and influenza, hospitalisation length of stay (LoS), intensive care unit (ICU) admissions, ICU LoS, direct medical costs and in-hospital mortality were assessed descriptively using routine data from four hospitals over a two-year observation period (01/04/2021-31/03/2023).
RESULTS: There were 13,242 ARI hospitalisations, of which 98.8% were from lower respiratory tract disease. Microbiology-confirmed positive tests versus ICD-10-coded ARI hospitalisations were 2.5, 1.3 and 1.1 times higher for RSV (210 versus 84), influenza (473 versus 376) and COVID-19 (2,768 versus 2,488), respectively. Median hospitalisation LoS for RSV and influenza were 8 and 7 days; ICU admission frequency was 4.3% and 5.7%, with a median ICU LoS of 5 and 6 days. Median direct healthcare costs were €4,108 (5th-95th percentile: €2,963-€8,101) and €2,831 (€2,554-€6,156), and in-hospital mortality rates were 1.93 (95% confidence interval: 0.97-3.46) and 2.21 (1.46-3.22) for RSV and influenza, respectively.
CONCLUSIONS: This study demonstrates that using ICD-10 codes for RSV diagnosis may substantially underestimate RSV BoD in Spain. RSV was associated with a significant BoD in microbiology-confirmed adult patients, comparable to influenza.
METHODS: ARI-related hospital admissions were identified using ICD-10 coding. RSV, influenza and COVID-19 microbiology-confirmed positive test data for each of these hospitalisations were compared against ICD-10 diagnoses. For RSV and influenza, hospitalisation length of stay (LoS), intensive care unit (ICU) admissions, ICU LoS, direct medical costs and in-hospital mortality were assessed descriptively using routine data from four hospitals over a two-year observation period (01/04/2021-31/03/2023).
RESULTS: There were 13,242 ARI hospitalisations, of which 98.8% were from lower respiratory tract disease. Microbiology-confirmed positive tests versus ICD-10-coded ARI hospitalisations were 2.5, 1.3 and 1.1 times higher for RSV (210 versus 84), influenza (473 versus 376) and COVID-19 (2,768 versus 2,488), respectively. Median hospitalisation LoS for RSV and influenza were 8 and 7 days; ICU admission frequency was 4.3% and 5.7%, with a median ICU LoS of 5 and 6 days. Median direct healthcare costs were €4,108 (5th-95th percentile: €2,963-€8,101) and €2,831 (€2,554-€6,156), and in-hospital mortality rates were 1.93 (95% confidence interval: 0.97-3.46) and 2.21 (1.46-3.22) for RSV and influenza, respectively.
CONCLUSIONS: This study demonstrates that using ICD-10 codes for RSV diagnosis may substantially underestimate RSV BoD in Spain. RSV was associated with a significant BoD in microbiology-confirmed adult patients, comparable to influenza.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE117
Topic
Economic Evaluation, Epidemiology & Public Health, Study Approaches
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Infectious Disease (non-vaccine), Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)