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Background <p>Respiratory syncytial virus (RSV) incidence among adults in Finland remains underreported, mostly due to non-specific RSV symptoms, infrequent standard-of-care testing, and reduced sensitivity of single-specimen nasal/nasopharyngeal RT-PCR testing among adults. We retrospectively estimated RSV-attributable incidence of all-cause respiratory hospitalizations and mortality in adults in Finland between 2011 and 2019.</p> Methods <p>We estimated incidence using time-series modeling by comparing the week-to-week variability in RSV diagnosis trends with the week-to-week variability in the events with any respiratory diagnosis. Weekly aggregated data on all-cause respiratory hospitalizations and deaths (J00–J99) were obtained from the Care Register for Health Care (HILMO) and Statistics Finland, respectively. Hospitalization data on RSV and influenza were obtained from HILMO. Data on all-cause respiratory diseases for age groups that showed a seasonal pattern were included in a hierarchical Bayesian model, sharing information across the age groups while accounting for seasonal fluctuations, and RSV and influenza circulation.</p> Results <p>The highest annual incidence rates of RSV-attributable respiratory hospitalizations were observed in adults aged ≥ 75 years (range 145–240 hospitalizations per 100,000 person-years), on average 7-fold higher than in adults aged 45–64 years (range 19–37 hospitalizations per 100,000 person-years). A biennial (low-high incidence) fluctuation of all-cause respiratory hospitalization incidence and mortality rate was observed in all age groups. A seasonal pattern for all-cause respiratory deaths was observed only for adults aged ≥ 75 years, who had an estimated RSV-attributable mortality rate of 8–14 deaths per 100,000 person-years. RSV-attributable deaths accounted for 3–5% of all all-cause respiratory deaths in this age group.</p> Conclusions <p>Respiratory morbidity and mortality associated with RSV infection among adults in Finland are substantial, particularly for those aged ≥ 75 years. Newly introduced RSV vaccines, which appear effective for the oldest adults, could have a substantial impact on this respiratory disease burden.</p>

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Estimated Incidence of All-Cause Respiratory Hospitalizations and Deaths Attributable to Respiratory Syncytial Virus Infections in Adults in Finland between 2011 and 2019: A Retrospective Database Study

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  • 发表日期：

    2026年1月9日

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  • Robin Bruyndonckx,
  • Aleksandra Polkowska-Kramek,
  • Caihua Liang,
  • Mikko Kosunen,
  • Olli-Pekka Hätinen,
  • Mikel Esnaola,
  • Maribel Casas,
  • Pimnara Peerawaranun,
  • Worku Biyadgie Ewnetu,
  • Bradford D. Gessner,
  • Elizabeth Begier

摘要

Background

Respiratory syncytial virus (RSV) incidence among adults in Finland remains underreported, mostly due to non-specific RSV symptoms, infrequent standard-of-care testing, and reduced sensitivity of single-specimen nasal/nasopharyngeal RT-PCR testing among adults. We retrospectively estimated RSV-attributable incidence of all-cause respiratory hospitalizations and mortality in adults in Finland between 2011 and 2019.

Methods

We estimated incidence using time-series modeling by comparing the week-to-week variability in RSV diagnosis trends with the week-to-week variability in the events with any respiratory diagnosis. Weekly aggregated data on all-cause respiratory hospitalizations and deaths (J00–J99) were obtained from the Care Register for Health Care (HILMO) and Statistics Finland, respectively. Hospitalization data on RSV and influenza were obtained from HILMO. Data on all-cause respiratory diseases for age groups that showed a seasonal pattern were included in a hierarchical Bayesian model, sharing information across the age groups while accounting for seasonal fluctuations, and RSV and influenza circulation.

Results

The highest annual incidence rates of RSV-attributable respiratory hospitalizations were observed in adults aged ≥ 75 years (range 145–240 hospitalizations per 100,000 person-years), on average 7-fold higher than in adults aged 45–64 years (range 19–37 hospitalizations per 100,000 person-years). A biennial (low-high incidence) fluctuation of all-cause respiratory hospitalization incidence and mortality rate was observed in all age groups. A seasonal pattern for all-cause respiratory deaths was observed only for adults aged ≥ 75 years, who had an estimated RSV-attributable mortality rate of 8–14 deaths per 100,000 person-years. RSV-attributable deaths accounted for 3–5% of all all-cause respiratory deaths in this age group.

Conclusions

Respiratory morbidity and mortality associated with RSV infection among adults in Finland are substantial, particularly for those aged ≥ 75 years. Newly introduced RSV vaccines, which appear effective for the oldest adults, could have a substantial impact on this respiratory disease burden.