BMJ open · 2026
Incidence of respiratory syncytial virus in adults ≥50 years during and following the COVID-19 pandemic in upper midwest USA: a community-based prospective cohort study.
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Takahashi Paul Y, Saeedi Pouya, Wi Chung-Il, Pignolo Robert J, Bosch Wendelyn, King Katherine S, Hickman Joel, Ryu Euijung, Natoli Traci, Ihrke Kathy, Yao Joseph, Binnicker Matthew, Sieler Steph, Speiser Lisa, Hidaka Brandon, Damaso Silvia, Pircon Jean-Yves, Juhn Young
Аннотация
OBJECTIVE: Respiratory syncytial virus (RSV) is an important viral pathogen in children, older adults and adults with certain high-risk conditions. In our prospective community-based cohort study of adults 50 years and older before the COVID-19 pandemic, the incidence of RSV acute respiratory infection (ARI) was 48.6 cases/1000 person-years (PY), which decreased to near zero during the COVID-19 pandemic. Our objective was to determine the incidence of RSV-ARI during the 2 years following the initial phase of the pandemic (2021-2022 and 2022-2023).
DESIGN: This is a community-based prospective cohort study.
SETTING: Adults living in southeast Minnesota from October 2021 to September 2022 (year 3) and October 2022 to September 2023 (year 4).
PARTICIPANTS: Adults≥50 years (n=2500).
PRIMARY AND SECONDARY OUTCOMES: We calculated incidence and attack rates for RSV-ARI as primary outcome and reported hospitalisations, pneumonia and death following ARI as secondary outcome.
RESULTS: There were 2500 participants in the study with a mean age of 68.2 years (SD 9.3) at the start of year 3. Participants were predominantly female (60%), non-Hispanic white (96%) and residing in urban areas (76%). The incidence rate of RSV-ARI was 6.12/1000 PY (95% CI 3.42 to 10.09) in 2021-2022 and 16.40/1000 PY (95% CI 11.66 to 22.42) in 2022-2023. We noted higher attack rates of RSV-ARI during the winter months. There were no hospitalisations, pneumonia or deaths within 30 days of RSV-ARI.
CONCLUSIONS: Compared with the period before the COVID-19 pandemic, RSV-ARI incidence was lower in both 2021-2022 and 2022-2023 periods. In 2022-2023, the incidence increased 2.7-fold compared with the 2021-2022 period. The observed incidence rates, particularly the significant increase in the most recent season, underscore the continued public health relevance of RSV-ARI and support the rationale for ongoing RSV vaccination efforts to mitigate its overall burden in the population.
DESIGN: This is a community-based prospective cohort study.
SETTING: Adults living in southeast Minnesota from October 2021 to September 2022 (year 3) and October 2022 to September 2023 (year 4).
PARTICIPANTS: Adults≥50 years (n=2500).
PRIMARY AND SECONDARY OUTCOMES: We calculated incidence and attack rates for RSV-ARI as primary outcome and reported hospitalisations, pneumonia and death following ARI as secondary outcome.
RESULTS: There were 2500 participants in the study with a mean age of 68.2 years (SD 9.3) at the start of year 3. Participants were predominantly female (60%), non-Hispanic white (96%) and residing in urban areas (76%). The incidence rate of RSV-ARI was 6.12/1000 PY (95% CI 3.42 to 10.09) in 2021-2022 and 16.40/1000 PY (95% CI 11.66 to 22.42) in 2022-2023. We noted higher attack rates of RSV-ARI during the winter months. There were no hospitalisations, pneumonia or deaths within 30 days of RSV-ARI.
CONCLUSIONS: Compared with the period before the COVID-19 pandemic, RSV-ARI incidence was lower in both 2021-2022 and 2022-2023 periods. In 2022-2023, the incidence increased 2.7-fold compared with the 2021-2022 period. The observed incidence rates, particularly the significant increase in the most recent season, underscore the continued public health relevance of RSV-ARI and support the rationale for ongoing RSV vaccination efforts to mitigate its overall burden in the population.