RSV vs. influenza among older adults: are rates of complications comparable?

Reviewed by Jose Lucar, MD, The George Washington University

Bottom line: Mortality associated with both RSV and influenza disproportionately affects elderly persons with similar rates for both infections, however, RSV disease in this population may be more severe than that associated with influenza and should inform shared clinical decision-making when assessing the benefit of RSV vaccination.

Respiratory syncytial virus (RSV) infection is the most common respiratory pathogen in infants and young children worldwide, but complications in the elderly population are gaining increased attention based on better diagnostics and vaccine development. In this study, Caryn Giselle Recto and colleagues conducted a single-center retrospective study in a French university hospital between 2016-2022 to compare all-cause mortality at day 30 and secondary complications between RSV and influenza among 558 emergency department patients aged ≥75 years (125 with RSV and 433 with influenza). Mortality rates at day 30 were comparable between both groups (RSV 9.6%, Influenza 9.7%; p = 0.973). However, rates of complications such as consolidative pneumonia, hospitalization rates, ICU admissions, and length of stay were significantly higher in the RSV group. Despite the known limitations of retrospective, single-center studies, these results highlight the importance of further developing therapeutic and preventive interventions against RSV infection in the elderly and should inform shared clinical decision-making when assessing the benefit of RSV vaccination.

Recto C, Fourati S, Khellaf M, Pawlotsky JM, et al. Respiratory syncytial virus vs. Influenza virus infection: mortality and morbidity comparison over 7 epidemic seasons in an elderly population. J Infect Dis. 2024 Apr 4:jiae171. doi: 10.1093/infdis/jiae171. Epub ahead of print. PMID: 38574192.

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