Lisa Kuhns, PhD
Targeted interventions are needed to reduce the burden of respiratory syncytial virus (RSV) infection, particularly in low sociodemographic index (SDI) regions and among older adults, according to results of a study published in the International Journal of Infectious Diseases.
It is well known that infants, younger children, and older adults are at high risk for RSV infection. However, data on the temporal trends of the differential impact of RSV infection across age groups has not been thoroughly explored. Thus, researchers analyzed data from the Global Burden of Disease (GBD) 2019 to assess the global burden of RSV by age group, region, and sex.
The GBD provides data from 1990 to 2019 on 369 diseases, injuries, and risk factors in 204 countries and territories. Using spatial-temporal aggregation analysis, joinpoint regression models, and an age-period-cohort model, the researchers extracted the annual RSV-associated mortality rate and calculated age-standardized rates of mortality to explore global and temporal trends in the GBD RSV data.
The global rate of mortality due to RSV infection in 2019 was 338,495 (95% uncertainty interval [UI], 126,555-667,109). When stratified by SDI, the highest overall mortality rate was observed in low-SDI regions (98,333; 95% UI, 40,781-174,404).
The age-period-cohort model indicated a similar trend for RSV-associated mortality in 2019. The global rate of mortality in this model was 4.79 per 100,000 (95% UI, 1.82-9.32), with the highest rates occurring in low-SDI regions (10.26 per 100,000; 95% UI, 3.80-20.86). Stratified by sex, the model showed that global RSV-associated mortality rates were higher among men (5.33, per 100,000; 95% UI, 1.95-10.48) compared with women (4.47 per 100,000; 95% UI, 1.71-8.49).
In analyzing temporal changes in RSV data from 1990 to 2019 by age groups, the researchers found that the mortality rate among children younger than 5 years decreased from 65.54 (95% UI, 28.37-110.42) to 18.68 (95% UI, 8.20-31.96) per 100,000, whereas mortality rates increased among adults overall. Moreover, the global mortality rate ratio between adults older than 70 years and children younger than 5 years increased from 0.57 in 1990 to 1.85 in 2019.
Further analysis showed that the overall rate of mortality due RSV-associated lower respiratory infection decreased over this time period, though rates trended upward among people aged 70 years and older.
Study limitations include the inability to assess the impact of COVID-19 infection on RSV-associated mortality as RSV data were only captured up to 2019. Further, the 5-year mean rate of RSV-associated mortality in the age-period-cohort model was determined via data captured from a single year.
According to the researchers, “[I]t is essential to develop targeted strategies to prevent, control, diagnose, and treat RSV infection among children and [older adults], taking into account the disease burden and characteristics.”
Du Y, Yan R, Wu X, et al. Global burden and trends of respiratory syncytial virus infection across different age groups from 1990 to 2019: a systematic analysis of the Global Burden of Disease 2019 Study. Int J Infect Dis. 2023;135:70-76. doi:10.1016/j.ijid.2023.08.008