Anna Puggina

Respiratory syncytial virus (RSV) is a leading cause of acute respiratory infection and can lead to severe disease in older adults or those with comorbidities. This analysis aims to evaluate the demographic and clinical burden of RSV hospitalizations among older adults in Italy and inform potential preventative strategies. Adults aged ≥50 years with ≥1 hospitalization discharge diagnosis for RSV from 2010 to 2021 were included. Demographic characteristics before the first RSV hospitalization and clinical outcomes during this hospitalization and the 12 months following are described. Of the 243 patients, mean (SD) age was 73.7 (13.1) years, 40.7% were male, and the most common comorbidities were chronic obstructive pulmonary disease (37.9%), diabetes (21.8%), and heart failure (15.2%). Mean length of index hospitalization was 17.0 days, during which 9.1% of patients died. At index or during the 12-month follow-up, 5.8% had an intensive care unit admission, 61.3% were prescribed antibiotics, 8.2% had a stroke, and 3.3% had an acute myocardial infarction. During the 12-month follow-up, approximately, half of patients experienced worsening of preexisting comorbidities, with notable rates of re-hospitalization and mortality (44.4% and 29.6%). This study shows a high clinical burden of RSV among older adults in Italy, emphasizing a need for improved RSV surveillance, and may guide policymakers and healthcare providers in making informed recommendations for, and implementation of, RSV vaccination in Italy.

Background/Objectives The economic impact of respiratory syncytial virus (RSV) in Italy is not well defined. This analysis assessed the economic outcomes of RSV-hospitalized patients aged ≥ 60 years in Italy. Methods: Healthcare resource utilization and direct healthcare costs during the first RSV hospitalization and 12-month follow-up were collected from Italian administrative databases. A propensity-score-matched (PSM) analysis was performed between patients hospitalized for RSV and those hospitalized for any cause (without an RSV diagnosis). Results: Among 201 patients, an average of 1.95 hospitalizations, 19.38 prescriptions, and 7.11 outpatient services were reported during the first RSV hospitalization and the following 12 months. The mean direct healthcare costs were EUR 11,599 (related to hospitalization [79%], prescriptions [16%], and outpatient services [5%]). Following PSM analyses, direct healthcare costs were 15% higher for RSV-hospitalized patients versus those hospitalized for any cause (EUR 9369 versus EUR 8173; p < 0.05), driven by differences in hospitalizations (EUR 7477 versus EUR 6327; p < 0.05) and intensive care unit admissions (EUR 818 versus EUR 178; p = 0.001). Conclusions: Despite a limited sample size, this study reports a substantial economic burden associated with RSV-hospitalized patients aged ≥ 60 years in Italy. The results provide important evidence to inform preventative RSV strategies to reduce the economic burden on the Italian National Health Service.

Background: Respiratory syncytial virus (RSV) is a common cause of acute respiratory infection (ARI). The risk of severe RSV outcomes is higher among older adults (OAs) and individuals with chronic diseases (high risk, HR). AS01_E-adjuvanted RSV preFusion protein 3 OA vaccine (adjuvanted RSVPreF3 OA is approved for the prevention of lower respiratory tract disease [LRTD] due to RSV in OAs). The objective of this study was to assess the potential public health impact of an RSV vaccination program using adjuvanted RSVPreF3 OA in adults ≥75 years (y) and HR adults ≥60 y in Italy. Methods: A static multi-cohort Markov model was used to estimate the number of RSV cases and associated health outcomes projected in adults ≥75 y and HR adults ≥60 y with no RSV vaccination or with a single dose of adjuvanted RSVPreF3 OA. Epidemiological, healthcare resource use and cost data were obtained from the scientific literature. Vaccine efficacy and waning inputs were based on results from the AReSVi-006 phase III clinical trial. Several scenarios for vaccine coverage were explored. Results: Assuming the target vaccination rate for influenza vaccination in Italy (75%), the model predicted that vaccinating Italian adults ≥75 y and the HR population ≥ 60 y with adjuvanted RSVPreF3 OA would reduce the number of RSV-LRTD events by 43%, leading to a reduction in associated emergency department visits, hospitalizations, complications, deaths, and direct healthcare costs over a 3-year period. Conclusions: The vaccination of Italians aged ≥ 75 y and HR individuals aged ≥ 60 y using the adjuvanted RSVPreF3 OA vaccine has the potential to offer substantial public health benefits by reducing the burden of RSV disease.