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RSV in Older Adults with Chronic Respiratory Disease

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Summary

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Risk of Severe RSV Disease in Older Adults with COPD or Asthma

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Exacerbation of COPD and Asthma

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Persistent RSV Infection and Lung Function

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Summary

icon-showing-a-cartoon-of-an-inhaler.

Older adults with chronic obstructive pulmonary disease (COPD) or asthma are at increased risk of severe respiratory syncytial virus (RSV) disease vs those without COPD or asthma.1,4,5

icon-showing-a-cartoon-of-a-hospital-building.

Exacerbations of COPD or asthma are common in older adults hospitalised with RSV.2

icon-showing-a-cartoon-of-lungs.

Persistent RSV infection is associated with decline in lung function and higher airway inflammation in patients with COPD.3

Risk of Severe RSV Disease in Older Adults with COPD or Asthma

In a large prospective study in two regions of New York State, USA (2017–2020; N=1099), hospitalisation rates for RSV were higher in older adults (aged 50–64 and ≥65 years) with certain underlying comorbidities*, including COPD and asthma.1

Table 1. Estimated Annual RSV Infection Incidence Rates per 100 000 Hospitalised Persons with and without COPD or Asthma, and Incidence Rate Ratios (IRRs)

  Rochester, New York New York City
Comorbidity and Age Incidence Rate   Incidence Rate  
  With Condition Without Condition IRR† (95% CI) With Condition Without Condition IRR† (95% CI)
COPD
50–64 y 204.76 32.25 6.35 (2.00–20.11) 210.31 33.38 6.30 (3.75–10.58)
≥65 y 1077.36 80.32 13.41 (4.29–41.98) 529.17 150.68 3.51 (2.63–4.69)
Asthma
50–64 y 90.24 38.64 2.34 (0.74–7.39)‡ 110.87 30.80 3.60 (2.24–5.79)
≥65 y 261.43 103.93 2.52 (0.81–7.86)‡ 369.92 162.71 2.27 (1.67–3.09

Table independently created for GSK from the original data from Branche AR et al. Clin Infect Dis 2022;74(6):1004–1011
*comorbidities of interest were COPD, asthma, diabetes, coronary artery disease, congestive heart failure
†Incidence rate ratio among people with each comorbidity vs without it
‡the incidence rate ratio was not statistically significant
CI = Confidence Interval

Exacerbation of COPD and Asthma

An observational, retrospective, cohort study was conducted in Kaiser Permanente, Southern California, to characterise the clinical epidemiology, signs and symptoms, and outcomes of severe RSV in hospitalised patients.2

Figure 1. Comorbidities Among Patients Aged ≥60 Years who were Hospitalised & Tested Positive for RSV in Kaiser Permanente Southern California, USA, 2011–2015 (N=664)*,2

figure-showing-a-bar-chart-in-the-top-panel-and-two-figures-in-the-bottom-panel.-the-bar-chart-in-the-top-panel-depicts-the-most-common-comorbidities-among-664-patients-aged-60-years-or-above-who-were-hospitalized-with-r-s-v-in-Kaiser-Permanente-Southern-California-USA-between-2011-and-2015,-reported-from-a-cohort-study- by-Tseng-et-al.-the-most-common-comorbidities-were-congestive-heart-failure-and-diabetes,-both-were-reported-in-38.6-percent-of-patients.-c-o-p-d-was-reported-in-35.4-percent-of-patients,-and-asthma-was-reported-in-28.6-percent-of-patients.-the-two-figures-in-the-bottom-panel-show-the-proportion-of-patients-who-experienced-exacerbation-events-in-the-Tseng-et-al-cohort-study.-of-the-patients-with-c-o-p-d,-80-percent-experienced-c-o-p-d-exacerbation-during-r-s-v-related-hospitalization.-of-the-patients-with-asthma-50-percent-experienced-asthma-exacerbation-during-r-s-v-related-hospitalization.

Figures independently created for GSK from the original data from Tseng HF et al. J Infect Dis 2020;222(8):1298–1310
*Comorbidities were present in the year before hospital admissions;

Persistent RSV Infection and Lung Function

Persistent RSV infection in patients with COPD is associated with accelerated decline in lung function.3

A prospective study evaluated the consequences of RSV persistence in adults with COPD whilst in the stable state, over a period of 2 years (N=74). It showed that repeated positive tests (>50% samples over 2 year period) for RSV were associated with increased rates of decline in forced expiratory volume in 1 second (FEV1) readings and higher inflammatory parameters (vs. the cohort whose samples were RSV +ve ≤50% of the time).3

Figure 2. Relationship Between RSV Detection Pattern And FEV1 Decline Over Study Period3

line-chart-showing-the-relationship-between-r-s-v-detection-pattern-and-forced-expiratory-volume-in-1-second-over-the-study-period-in-patients-with-c-o-p-d.-patients-in-the-high-r-s-v-group-showed-greater-decline-in-forced-expiratory-volume-in-1-second-compared-with-the-low-r-s-v-group.-the-difference-in-the-rate-of-decline-between-these-groups-was-significant-with-a-p-value-of-0.01.

Graph redrawn from Wilkinson TM et al. Am J Respir Crit Care Med 2006;173(8):871–876
FEV1 = forced expiratory volume in 1 second; PCR = polymerase chain reaction

Learn more about RSV disease and its burden in adults:

RSV, Virus

RSV Disease Overview

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RSV, Virus

Risk Factors and Clinical Burden of RSV in Older Adults

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RSV, Virus

RSV Diagnosis, Prevention, & Management

Click here to learn more about RSV diagnosis, prevention & management

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Abbreviations

CI, confidence interval; COPD, chronic obstructive pulmonary disease; FEV1, forced expiratory volume in 1 second; RSV, respiratory syncytial virus.

References

  1. Branche AR et al. Clin Infect Dis 2022;74(6):1004–1011.
  2. Tseng HF et al. J Infect Dis 2020;222(8):1298–1310.
  3. Wilkinson TM et al. Am J Respir Crit Care Med 2006;173(8):871–876.
  4. Belongia EA et al. Open Forum Infect Dis 2018;5(12):ofy316.
  5. Wyffels V et al. Adv Ther 2020;37(3):1203-1217

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November 2024 | NX-GB-GVU-WCNT-240002 (V1.0)