THE HIDDEN BURDEN OF RESPIRATORY SYNCYTIAL VIRUS: INCIDENCE TRENDS AND COMORBIDITY ASSOCIATED RISK IN OLDER ADULTS IN GERMANY, 2007 TO 2023
Author(s)
Maren Steinmann, MSc1, Silke Frey, MSc2, Berit Lange, PhD3, Birgitta Weltermann, PhD4, Wolfgang Greiner, PhD1, Manuela Harries, PhD3.
1School of Public Health, Department for Health Economics and Health Care Management, Bielefeld University, Bielefeld, Germany, 2Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany, 3Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany, 4University Hospital Bonn, Institute of General Practice and Family Medicine, Germany.
1School of Public Health, Department for Health Economics and Health Care Management, Bielefeld University, Bielefeld, Germany, 2Institute of General Practice and Family Medicine, University Hospital Bonn, Bonn, Germany, 3Department for Epidemiology, Helmholtz Centre for Infection Research, Braunschweig, Germany, 4University Hospital Bonn, Institute of General Practice and Family Medicine, Germany.
OBJECTIVES: Respiratory syncytial virus (RSV) represents a significant public health challenge among older adults, with considerable clinical and economic consequences. While hospitalization rates increase with age, particularly among adults aged ≥80 years, the epidemiology of RSV in older adults remains incompletely understood. This study estimates age and sex standardized incidence of RSV hospitalizations and examines the association between comorbidities and RSV risk.
METHODS: This analysis used claims data from a large German statutory health insurance for adults aged ≥55 from 2007 to 2023. RSV hospitalizations were identified using ICD-10 codes J21.1, J20.5, J21.0, and B97.4 in inpatient records, with broader respiratory codes included in sensitivity analyses. Clinically relevant comorbidities were assessed based on diagnosis documentation in at least four quarters. Age and sex standardized incidence per 100,000 person-years was calculated and projected to official German population statistics. Odds ratios were estimated using logistic regression adjusted for age, sex, and federal state.
RESULTS: Standardized RSV incidence increased from 0.2 per 100,000 person-years in 2007 to 15-20 by 2023, with average annual estimates of around 230 cases (range: 4-1,200). Over this period the mean age of affected individuals increased from 66.2 years to 77.1, and incidence remained consistently higher in females (10.47) than males (7.53 per 100,000 person-years). Comorbidity burden intensified, as reflected in rising Elixhauser scores (3.1 in 2007 to 4.7 in 2023). Cardiovascular disease, COPD, and diabetes were most frequently documented among RSV cases, while immunodeficiency and hematological malignancy were less prevalent. Logistic regression revealed elevated odds ratios across most comorbidities, with immunodeficiency (OR 24.09) and COPD (OR 15.27) showing the strongest associations.
CONCLUSIONS: These preliminary results suggest a growing RSV burden among older adults. Final estimates and comorbidity clustering analyses will refine these findings and inform RSV prevention strategies.
METHODS: This analysis used claims data from a large German statutory health insurance for adults aged ≥55 from 2007 to 2023. RSV hospitalizations were identified using ICD-10 codes J21.1, J20.5, J21.0, and B97.4 in inpatient records, with broader respiratory codes included in sensitivity analyses. Clinically relevant comorbidities were assessed based on diagnosis documentation in at least four quarters. Age and sex standardized incidence per 100,000 person-years was calculated and projected to official German population statistics. Odds ratios were estimated using logistic regression adjusted for age, sex, and federal state.
RESULTS: Standardized RSV incidence increased from 0.2 per 100,000 person-years in 2007 to 15-20 by 2023, with average annual estimates of around 230 cases (range: 4-1,200). Over this period the mean age of affected individuals increased from 66.2 years to 77.1, and incidence remained consistently higher in females (10.47) than males (7.53 per 100,000 person-years). Comorbidity burden intensified, as reflected in rising Elixhauser scores (3.1 in 2007 to 4.7 in 2023). Cardiovascular disease, COPD, and diabetes were most frequently documented among RSV cases, while immunodeficiency and hematological malignancy were less prevalent. Logistic regression revealed elevated odds ratios across most comorbidities, with immunodeficiency (OR 24.09) and COPD (OR 15.27) showing the strongest associations.
CONCLUSIONS: These preliminary results suggest a growing RSV burden among older adults. Final estimates and comorbidity clustering analyses will refine these findings and inform RSV prevention strategies.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH68
Topic
Epidemiology & Public Health, Real World Data & Information Systems
Disease
Infectious Disease (non-vaccine), Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)