# P-645. The Disease Burden of Respiratory Syncytial Virus-Related Hospitalization in Taiwanese Adults: A National Health Insurance Database Study

## TL;DR

This study shows that RSV hospitalizations in Taiwanese adults, especially older adults and those with health issues, are a significant and growing problem with high medical costs.

## Contribution

The study quantifies the rising disease burden of RSV-related hospitalizations in Taiwanese adults using national health insurance data.

## Key findings

- RSV hospitalizations increased fourfold in late 2020 compared to previous years.
- Older adults (≥ 50 years) and those with comorbidities face higher severity and ICU admission risks.
- Medical costs for RSV-related hospitalizations are substantial, with ICU admissions being particularly expensive.

## Abstract

Respiratory Syncytial Virus (RSV) remains a major cause of respiratory tract infections among older adults, especially among the elderly and those with comorbidities. This study investigated the incidence and disease burden of RSV-related hospitalization in Taiwanese adults.

Our retrospective study was conducted among adults aged ≥ 18 years utilizing the National Health Insurance Research Database between July 2017-December 2021. Cases were defined as having ≥ 1 RSV-related hospitalization via the corresponding ICD-10 disease codes. The incidence, severity, risk factors, and medical costs related to RSV hospitalizations were examined.

Among 226 RSV-related hospitalizations, 66.8% occurred in older adults aged ≥ 60 years. Of these, 39.4% were aged ≥ 75 years. There was a 4-fold increase in the incidence of RSV-related hospitalizations in Q4 2020 (0.20 per 100,000 population) compared to 2017-2019 (0.05-0.07). Mean of hospitalization was 32 days, with 63.3% of cases requiring oxygen supplementation, 26.5% with intensive care unit (ICU) admission, and 23.0% with ventilator use. Among comorbid patients, congestive heart failure (CHF)/coronary artery disease (CAD)/stroke and chronic kidney disease were 2 times more reported to be admitted into the ICU (odds ratio, OR: 2.50; p=0.01 and 2.28; p=0.04 respectively). Risk factors for infection severity included being adults aged ≥ 50 years (ref: age 18-49 years; OR: 3.14-8.90, p< 0.05), having asthma/chronic obstructive pulmonary disease (COPD) (3.69; p< 0.05), and CHF/CAD/stroke (3.20; p< 0.05). Patients aged ≥ 75 years were the highest risk group for CHF/CAD/stroke (55.7%) and asthma/COPD (45.5%) for RSV-related hospitalizations. Mean medical costs were 9,209 USD for hospitalization, 4,786 USD for ICU admission, 2,720 USD for outpatient visit, and 259 USD for emergency room visits.

Our study reveals the underestimated burden of RSV-related hospitalizations among Taiwanese adults, particularly those aged ≥ 50 and with comorbidities. The findings underscore the importance of RSV-vaccination and early intervention, especially among high-risk groups. Efforts should prioritize reducing the clinical and financial burden of RSV.

Wei-Ting Chen, MD, MSD Taiwan: Employment Kai-Ting Chen, PhD, MSD Taiwan: Employment