Burden of Disease of Respiratory Syncytial Virus in Older Adults and Adults Considered at High Risk of Severe Infection
Bibliographic record
Abstract
Abstract Background Vaccine products for adults have increased interest in understanding Canada’s respiratory syncytial virus (RSV) burden in older adults and adults considered at high risk of severe infection. Objective To characterize the burden of RSV disease in Canada by joint analysis of the published literature and hospitalization data from a healthcare administrative database. Methods Electronic databases of published literature were searched to identify studies and systematic reviews reporting data on outpatient visits, hospitalizations, intensive care unit (ICU) admissions and deaths associated with RSV infection in adults. For the hospitalization data analysis, hospital discharge records were extracted from the Canadian Institute of Health Information (CIHI) Discharge Abstract Database (DAD) for all patients admitted to an acute care facility for RSV infection defined by ICD-10 codes from 2010-2020 and 2021-2023. Results Overall, 26 studies, including 7 systematic reviews, were identified and summarized in the rapid review. Evidence suggests that medically attended RSV respiratory tract infections (RTI) are frequent causing 4.7 to 7.8% of symptomatic RTI in adults 60 years of age and older. Incidence of RSV RTI increases with age and presence of underlying medical conditions, such as cardiorespiratory disease, diabetes, and immunocompromising conditions. This trend was consistently observed across all RSV clinical outcomes of interest (i.e., hospitalization, ICU admission and death). Patients who reside in long-term care or other chronic care facilities have higher likelihood of severe clinical outcomes (i.e., ICU admission, receiving mechanical ventilation and/or death) compared to patients with other living situations upon hospital admission. Approximately 10% of older adults hospitalized with RSV infection require ICU admission. Although data are limited, evidence suggests that case fatality ratio (CFR) among those admitted to hospital varies between 5 and 10%. Some evidence suggests that RSV burden may be close to influenza burden in older adults. In general, the results from the Canadian hospitalization data support the rapid review findings Rates of hospitalization, ICU admission and death associated with RSV all increased with age, with 16% of hospitalizations resulting in ICU admission and with an in-hospital CFR of 9%. Conclusion In adults, risk of severe RSV outcomes in general increases with increasing age and presence of comorbidities.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.009 | 0.011 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".