OBJECTIVES: Respiratory syncytial virus (RSV) infection is contributing to substantial morbidity and mortality in adults. This is especially prominent in patients at increased risk of severe outcomes, such as those with comorbidities (e.g., diabetes, chronic cardiovascular and pulmonary diseases) or immunocompromised conditions. This systematic literature review aimed to summarize the economic and humanistic burden of RSV in adults.

METHODS: MEDLINE and Embase databases were used to search for studies on healthcare resource utilization (HCRU), direct and indirect (medical) costs, and quality of life (QoL) outcomes in high risk ≥18 years of age (YOA) and older adults (≥60YOA) with RSV. Studies published in English, Spanish, Chinese, Portuguese, and German language from North America (NA), Europe (EUR), Asia-Pacific (APAC) and Latin America (LATAM) between January 1, 2000 and July 4, 2023 were included. Included full-text studies were critically appraised using an adapted Joanna Briggs Institute checklist.

RESULTS: The search yielded a total of 6,463 unique records of which 171 studies were included for full text review. Most studies were conducted in NA (n=87), followed by EUR (n=48), APAC (n=34), and LATAM (n=5). The most investigated outcome was HCRU, accounting for 85% of all recorded outcomes, followed by direct medical costs (14%). Available data on indirect costs and QoL was very limited with only 5 studies reporting these outcomes for each outcome. In studies with a low risk of bias median hospital length of stay for RSV patients ranged between 4 and 47 days. Mean costs per hospitalization ranged between 2,290 USD and 77,765 USD.

CONCLUSIONS: This study shows a considerable body of evidence for the economic and humanistic burden of RSV infections in adults. However, heterogeneity in study designs and reported outcomes prevented us from pooling data. Further research is needed to assess the burden of RSV worldwide.